超声心动图联合H-FABP、cTnI及CK-MB在AMI诊断、病情评估中的应用

Application of echocardiography combined with H-FABP,cTnI and CK-MB in the diagnosis and evaluation of AMI

目的分析超声心动图联合心脏型脂肪酸结合蛋白(H-FABP)、肌钙蛋白I(cTcI)及肌酸激酶同工酶(CK-MB)检测在急性心肌梗死(AMI)早期诊断、病情评估中的价值。方法选取2020年6月至2021年10月中牟县人民医院收治的94例AMI患者(AMI组),采用心功能Killip分级评估将患者分为Ⅰ级、Ⅱ级和Ⅲ级三个亚组;另取同期在本院进行体检的82名健康者作为健康组。比较两组、AMI组不同心功能患者H-FABP、cTnI、CK-MB水平及超声心动图参数LVEF、LVEDD;绘制受试者工作特征(ROC)曲线分析超声心动图联合H-FABP、cTnI及CK-MB检测诊断AMI的价值。结果AMI组H-FABP、cTnI、CK-MB水平及LVEDD均明显高于健康组,LVEF低于健康组,差异有统计学意义(P<0.05)。AMI组根据心功能Killip分级评估分为Ⅰ级27例、Ⅱ级46例、Ⅲ级21例。不同心功能分级患者H-FABP、cTnI、CK-MB水平及LVEDD比较:Ⅰ级<Ⅱ级<Ⅲ级;LVEF比较:Ⅰ级>Ⅱ级>Ⅲ级,差异均有统计学意义(P<0.05)。ROC曲线显示,(H-FABP+cTnI+CK-MB+超声心动图)四者联合检测诊断AMI的敏感度和特异度分别为0.901、0.826,AUC=0.910,明显高于四者单独预测(P<0.05)。结论H-FABP、cTnI、CK-MB及超声心动图参数在AMI中存在异常表达,联合四者检测可有效评估AMI患者病情,提高诊断效能。

Objective To analyze the value of echocardiography combined with heart fatty acidbinding protein(H-FABP),cardiac troponinⅠ(cTnI)and creatine kinase isoenzyme(CK-MB)detection in the early diagnosis and evaluation of acute myocardial infarction(AMI).Methods 94 AMI patients admitted to Zhongmou County People’s Hospital from June 2020 to October 2021 were selected(AMI group),the patients were divided into three subgroups of gradeⅠ,gradeⅡand gradeⅢby heart function Killip grading;82 healthy patients who underwent physical examination in this hospital during the same period were selected as the healthy group.The levels of H-FABP,cTnI,CK-MB and echocardiographic parameters LVEF and LVEDD were compared between the two groups and the AMI group in patients with different cardiac functions;receiver operating characteristic(ROC)curves were drawn to analyze echocardiography combined with H-FABP,cTnI and the value of CK-MB detection in the diagnosis of AMI was evaluated.Results The levels of H-FABP,cTnI and CK-MB in the AMI group were significantly higher than those in the healthy group,the difference was statistically significant(P<0.05).The LVEF in the AMI group was lower than that in the healthy group,and the LVEDD was significantly higher than that in the healthy group.The difference was statistically significant(P<0.05).The AMI group was divided into 27 cases of gradeⅠ,46 cases of gradeⅡ,and 21 cases of gradeⅢaccording to the Killip classification of cardiac function.Comparison of H-FABP,cTnI,CK-MB levels and LVEDD in patients with different cardiac function grades:gradeⅠ<gradeⅡ<gradeⅢ;comparison of LVEF:gradeⅠ>gradeⅡ>gradeⅢ,the differences were statistically significant(P<0.05).The ROC curve showed that the sensitivity and specificity of the combined detection of the four(H-FABP+cTnI+CK-MB+echocardiography)in the diagnosis of AMI were 0.901 and 0.826,respectively;AUC=0.910,which was significantly higher than those predicted by the four alone(P<0.05).Conclusion H-FABP,cTnI,CK-MB and echocardiographic parameters are abnormally expressed in AMI.The combination of four tests can effectively evaluate the condition of AMI patients and improve the diagnostic efficiency.