心肌酶谱、肌钙蛋白、超敏C反应蛋白及脑钠肽联合检测对早期急性心肌梗死的诊断价值

Diagnostic Value of Combined Detection of Myocardial Enzyme Profile,Troponin,Hypersensitive C-Reactive Protein and Brain Natriuretic Peptide in Early Acute Myocardial infarction

目的探讨心肌酶谱、肌钙蛋白(CTn)、超敏C反应蛋白(hs-CRP)、脑钠肽(BNP)联合检测在早期急性心肌梗死(acute myocardial infarction,AMI)诊断中的临床价值。方法选取72例大庆龙南医院2020年1月—2022年1月收治的AMI患者作为观察组,另选取同期健康体检者60名作为对照组。所有入选研究对象均清晨采集空腹血检测肌酸激酶同工酶(CK-MB)、CTn、hs-CRP、BNP水平,比较两组血清学指标差异,并绘制ROC曲线,分析CK-MB、CTn、hs-CRP、BNP单独检测及联合检测在AMI中的早期诊断价值。结果观察组CKMB[(48.74±4.25)U/L]、CTn[(0.32±0.08)μg/L]、hs-CRP[(16.54±2.05)mg/L]、BNP水平[(318.52±45.96)pg/mL]高于对照组,差异有统计学意义(t=48.370、25.958、38.697、38.271,P<0.05);绘制ROC曲线结果显示,CK-MB、CTn、hs-CRP、BNP单独检测及联合检测曲线下面积(AUC)分别为:0.778、0.765、0.720、0.704、0.941,联合检测诊断价值最高。结论CK-MB、CTn、hs-CRP、BNP在早期AMI诊断中具有一定价值,联合检测诊断灵敏度、特异度更高,可减少漏诊、误诊发生,为AMI早期治疗提供重要指导。

Objective To explore the clinical value of combined detection of myocardial enzyme profile,troponin(CTn),hypersensitive C-reactive protein(hs-CRP)and brain natriuretic peptide(BNP)in the diagnosis of early acute myocardial infarction(AMI).Methods A total of 72 patients with AMI admitted to Daqing Longnan Hospital from January 2020 to January 2022 were selected as the observation group,and 60 healthy physical examination subjects during the same period were selected as the control group.Fasting blood of all subjects was collected in the early morning to detect the levels of creatine kinase isoenzyme(CK-MB),CTn,hs-CRP and BNP,and the differences of serological indexes between two groups were compared.ROC curve was drawn to analyze the early diagnostic value of CK-MB,CTn,hs-CRP and BNP alone and combined detection in AMI.Results The levels of CK-MB[(48.74±4.25)U/L],CTn[(0.32±0.08)μg/L],hs-CRP[(16.54±2.05)mg/L]and BNP[(318.52±45.96)pg/mL]in observation group were higher than those in control group,the difference was statistically significant(t=48.370,25.958,38.697,38.271,P<0.05);ROC curve results showed that the area under the curve(AUC)of CK-MB,CTn,hs-CRP and BNP were 0.778,0.765,0.720,0.704 and 0.941 respectively,indicating that the combined test had the highest diagnostic value.Conclusion CK-MB,CTn,hs-CRP and BNP have certain value in the early diagnosis of AMI.Combined detection has higher diagnostic sensitivity and specificity,which can reduce the occurrence of missed diagnosis and misdiagnosis,and provide important guidance for the early treatment of AMI.