NT-proBNP、D-dimer和cTnI三项联合检测在急性心肌梗死早期诊断中的应用价值

Application value of combined detection of NT-proBNP,D-dimer and cTnI in early diagnosis of acute myocardial infarction

目的 探讨急性心肌梗死早期诊断中应用N末端脑钠肽前体(NT-proBNP)、肌钙蛋白I(cTnI)及D-二聚体(D-dimer)联合检测的价值。方法 67例急性心肌梗死早期患者作为急性心肌梗死组,67例同期自愿参与研究的健康体检者作为对照组。两组均抽取3 ml肘静脉血,检测心肌标志物指标。观察两组NT-proBNP、D-dimer和cTnI的检测结果,分析三种心肌标志物单独检测及联合检测的阳性检出情况。结果 急性心肌梗死组NT-proBNP(3654.36±646.67)pg/ml、D-dimer(1.23±0.07)μg/ml和cTnI(23.14±2.14)ng/ml均高于对照组的(89.17±3.45)pg/ml、(0.46±0.02)μg/ml和(0.21±0.01)ng/ml,差异有统计学意义(P<0.05)。三种心肌标志物联合检测的诊断阳性率为98.51%,高于三种心肌标志物单独检测,差异有统计学意义(P<0.05)。结论 NT-proBNP、cTnI及D-dimer三项指标联合检测对于提升急性心肌梗死早期诊断阳性率具有明显效果,可作为急性心肌梗死发病后诊断与评估的重要指标,具有较高的临床应用价值。

Objective To discuss the value of combined detection of N-terminal pro-brain natriuretic peptide(NT-proBNP),D-dimer and cardiac troponin I(cTnI)in early diagnosis of acute myocardial infarction.Methods 67 patients with acute myocardial infarction in the early stage were selected as the acute myocardial infarction group,and 67 healthy subjects who volunteered to participate in the study during the same period were selected as the control group.In both groups,3 ml of elbow venous blood was drawn for the detection of myocardial marker indexes.The results of NT-proBNP,D-dimer and cTnI in both groups were observed,and the positive detection of the three myocardial markers alone and in combination was analyzed.Results The NT-proBNP(3654.36±646.67)pg/ml,D-dimer(1.23±0.07)μg/ml and cTnI(23.14±2.14)ng/ml in the acute myocardial infarction group were higher than(89.17±3.45)pg/ml,(0.46±0.02)μg/ml and(0.21±0.01)ng/ml in the control group,and the differences were statistically significant(P<0.05).The positive detection rate of the combined test of the three myocardial markers was 98.51%,which was higher than that of the three myocardial markers alone,and the difference was statistically significant(P<0.05).Conclusion The combined test of NT-proBNP,cTnI and D-dimer has obvious effect on improving the positive rate of early diagnosis of acute myocardial infarction,and can be used as an important index for diagnosis and evaluation after the onset of acute myocardial infarction,which has high clinical application value.