血清BNP、cTNⅠ及hs-CRP联合检查在急性冠脉综合征危险分层中的意义

Significance of Combined Examination of Serum BNP,cTNⅠand hs-CRP in Risk Stratification of Acute Coronary Syndrome

目的探讨血清脑钠肽(BNP)、心肌肌钙蛋白Ⅰ(cTNⅠ)和高敏C反应蛋白(hs-CRP)在急性冠状动脉综合征(ACS)患者血清中的表达水平和病情危险分层中的意义。方法选择2018年2月~2020年1月我院收治的ACS患者74例,其中35例急性心梗(AMI)者设为AMI组,39例不稳定心绞痛(UAP)患者设为UAP组,采用酶联免疫吸附法检测两组血清BNP浓度,化学发光法测定血清cTNⅠ浓度,免疫比浊法检测血清hs-CRP浓度,并根据贝叶斯定理计算上述指标鉴别AMI与UAP的临床价值。结果AMI组血清BNP、cTNⅠ及hs-CRP高于UAP组,差异有统计学意义(P<0.05);血清BNP+cTNⅠ+hs-CRP联合鉴别诊断AMI、UAP的敏感性、特异性均高于血清BNP、cTNⅠ、hs-CRP单独检测,差异有统计学意义(P<0.05);AMI组血浆cTNⅠ及hs-CRP与BNP呈正相关(r=0.730、0.380,P<0.05)。结论AMI患者血清炎症因子较UAP患者升高,且BNP+cTNⅠ+hs-CRP三者联合诊断AMI敏感性、特异性最高,可作为ACS患者危险分层评价和治疗的重要参考指。

Objective To explore the significance of serum brain natriuretic peptide(BNP),cardiac troponinⅠ(cTN I)and high sensitivity C-reactive protein(hs-CRP)in the serum of patients with acute coronary syndrome(ACS)and the significance of disease risk stratification.Methods A total of 74 ACS patients admitted to our hospital from February 2018 to January 2020 were selected.Among them,35 patients with acute myocardial infarction(AMI)were set as the AMI group and 39 patients with unstable angina(UAP)were set as the UAP group.Enzyme-linked immunosorbent method was used to detect the serum BNP concentration of the two groups,the chemiluminescence method was used to determine the serum cTNI concentration,the immunoturbidimetric method was used to detect the serum hs-CRP concentration,and the clinical value of the above indicators in distinguishing AMI from UAP was calculated according to Bayes'theorem.Results The serum BNP,cTNⅠand hs-CRP in the AMI group were higher than those in the UAP group,the difference was statistically significant(P<0.05);The sensitivity and specificity of the combined differential diagnosis of AMI and UAP with serum BNP+cTNⅠ+hs-CRP were higher than those of serum BNP,cTNⅠ,hs-CRP alone,the difference was statistically significant(P<0.05);Plasma cTNⅠand hs-CRP were positively correlated with BNP in the AMI group(r=0.730,0.380,P<0.05).Conclusion The serum inflammatory factors in AMI patients are higher than those in UAP patients,and the combination of BNP+cTNⅠ+hs-CRP in the diagnosis of AMI has the highest sensitivity and specificity,which can be used as an important reference for risk stratification evaluation and treatment of ACS patients.