Mb、BChE、cTnI及IL-6在心肌梗死中的表达水平及诊断价值研究

Expression and diagnostic value of Mb,BChE,cTnI and IL-6 in myocardial infarction

目的研究血清肌红蛋白(Mb)、丁酰胆碱酯酶(BChE)、肌钙蛋白I(cTnI)及白细胞介素-6(IL-6)在急性心肌梗死(AMI)患者中的表达水平及诊断价值。方法选取2020年10月至2021年10月保定市第二中心医院诊治的58例AMI患者作为AMI组,不稳定性心绞痛(UAP)42例作为UAP组,40例同期健康体检的健康人群作为对照组。采用酶联免疫吸附试验(ELISA)检测各组血清BChE、IL-6的表达水平。采用免疫荧光法检测血清Mb、cTnI的表达水平。统计学分析各组血清Mb、BChE、cTnI及IL-6表达水平的差异。单因素及多因素Logistic回归模型分析影响AMI发生的危险因素。受试者工作特征(ROC)曲线分析血清Mb、BChE、cTnI及IL-6单独及联合检测对AMI患者诊断价值。结果相比于UAP组和对照组,AMI组血清Mb、cTnI及IL-6的表达水平明显升高,BChE明显降低,差异有统计学意义(P<0.05)。单因素及多因素Logistic回归分析结果血清Mb≥119.25μg/L、BChE<6.17 kU/L、cTnI≥1.26μg/L和IL-6≥54.12 pg/mL是AMI发生的独立危险因素。ROC曲线分析结果血清Mb、BChE、cTnI、IL-6及联合检测的AUC分别为0.645、0.793、0.807、0.712及0.860。与单一指标相比,血清Mb、BChE、cTnI、IL-6联合检测对AMI诊断具有较高的预测价值(Z=5.730、4.212、3.473、4.875,P<0.05)。结论AMI患者血清Mb、cTnI、IL-6表达升高,BChE表达降低,四者是AMI发生的独立危险因素。联合检测预测血清Mb、BChE、cTnI、IL-6对AMI患者具有较高的诊断价值。

Objective To study the expression and diagnostic value of serum myoglobin(Mb),butyrylcholinesterase(BChE),troponin I(cTnI)and interleukin 6(IL-6)in patients with acute myocardial infarction(AMI).Methods A total of 58 patients with AMI diagnosed and treated in the Second Central Hospital of Baoding from October 2020 to October 2021 were selected as the AMI group,42 patients with unstable angina pectoris(UAP)were selected as the UAP group,and 40 healthy patients during the same period were selected as the control group.The expression of serum BChE and IL-6 in each group was detected by enzyme-linked immunosorbent assay(ELISA).Serum Mb and cTnI levels were detected by immunofluorescence method.The differences of serum Mb,BChE,cTnI and IL-6 levels in each group were statistically analyzed.Univariate and multivariate Logistic regression models were used to analyze the risk factors for AMI.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum Mb,BChE,cTnI and IL-6 alone and in combination in patients with AMI.Results Compared with the UAP group and the control group,the serum Mb,cTnI and IL-6 expression in the AMI group significantly increased,and the BChE expression significantly decreased,and the differences were statistically significant(P<0.05).Univariate and multivariate Logistic regression analysis showed that serum Mb≥119.25μg/L,BChE<6.17 kU/L,cTnI≥1.26μg/L and IL-6≥54.12 pg/mL were independent risk factors for AMI.The results of ROC curve analysis showed that the AUC of serum Mb,BChE,cTnI,IL-6 and combined detection were 0.645,0.793,0.807,0.712 and 0.860,respectively.Compared with the single detection,the combined detection of serum Mb,BChE,cTnI and IL-6 had higher predictive value for the diagnosis of AMI(Z=5.730,4.212,3.473,4.875,P<0.05).Conclusion The expression of serum Mb,cTnI and IL-6 in patients with AMI increase,and the expression of BChE decrease.All of them are independent predictors of the diagnosis of AMI.Combined detection of serum Mb,BChE,cTnI and IL-6 have high predictive value for the diagnosis of AMI.