急性心肌梗死并发阿斯综合征患者血清和肽素与Adropin水平联合检测的早期诊断价值研究

Study on the Early Diagnostic Value of Serum Copeptin and Adropin Levels in Pat ients with Acute Myocardial Inf arction Complicated with Adams-stokes Syndrome

目的探究急性心肌梗死(acute myocardial infarction,AMI)并发阿斯综合征(Adams-stokes syndrome)患者血清和肽素与Adropin水平联合检测的早期诊断价值研究。方法选取西安高新医院急诊科2016年1月~2020年1月收治的70例AMI并发阿斯综合征患者为观察组,另随机选取同期70例健康体检者为对照组。应用酶联免疫吸附法(ELISA)检测两组血清和肽素和Adropin的水平,绘制受试者ROC(receiver operating characteristic)工作曲线,评估血清和肽素,Adropin和两者联合检测的诊断特性。结果血清Adropin≥170.4 pg/ml为AMI并发阿斯综合征的临界值。两组AMI并发阿斯综合征发病后0,2,4和6 h时和肽素和血清中Adropin水平差异均具有统计学意义(U=5.325~294.457,均P<0.05)。不同发病时间点和肽素联合Adropin的异常率均高于其单独检测。和肽素灵敏度为91.02%,特异度为74.51%。血清中Adropin灵敏度为86.83%,特异度为77.98%,将两者联合灵敏度提高至92.71%,特异度提高至82.65%。结论血清和肽素联合Adropin在AMI并发阿斯综合征发病初期具有较高的异常率,其灵敏度和特异度均高于两者单独检测,可用于AMI并发阿斯综合征的早期识别和诊断。

Objective To explore the early diagnostic value of serum Copeptin and Adropin levels in patients with acute myocardial infarction(AMI)complicated with Adams-stokes syndrome.Methods A total of 70 patients with AMI combined with AS syndrome admitted to Department of Emergency of Xi’an Gaoxin Hospital from January 2016 to January 2020 were selected as the observation group,and 70 healthy physical examination subjects during the same period were randomly selected as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect the levels of serum Copeptin and Adropin in the two groups.Draw receiver operating characteristic(ROC)curves and evaluate the diagnostic properties of serum Copeptin,Adropin and the combination of the two respectively.Results Serum Adropin ≥170.4pg/ml was the critical value of AMI combined with AS syndrome.At 0,2,4 and 6h after onset of AMI combined with as syndrome,there were statistically significant differences in the levels of copeptin and Adropin in serum between the two groups(U=5.325~294.457,all P<0.05).The abnormal rate of copeptin and Adropin was higher than that of Adropin alone at different time points of onset.The sensitivity and specificity were 91.02% and 74.51%,respectively.The sensitivity and specificity of Adropin in serum were 86.83% and 77.98%,respectively.The combined sensitivity and specificity of Adropin were increased to 92.71%and 82.65%respectively.Conclusion In the early stage of AMI with AS syndrome,serum Adropin combined with copeptin has a high abnormal rate,and its sensitivity and specificity were both higher than the two alone,which can be used for the early identification and diagnosis of AMI with AS syndrome.