急性冠脉综合征患者实验室指标的诊断意义

Diagnostic significance of laboratory indicators in patients with acute coronary syndrome

目的探讨实验室指标在急性冠脉综合征(ACS)不同诊断分类中的水平与临床意义。方法以ST段抬高型心肌梗死(STEMI组)患者37例、非ST段抬高心肌梗死(NSTEMI组)患者64例、不稳定型心绞痛(UA组)患者34例及健康体检者(对照组)50例为研究对象,检测并比较心肌损伤标记物和炎症指标水平。结果3组ACS患者的WBC、NLR、cTnI、CK均高于对照组,STEMI组和NSTEMI组的NLR、cTnI、MYO、CK、CKMB、LDH、HBDH均高于UA组,差异有统计学意义(P<0.05)。将ACS按诊断分组对各指标进行Spearman相关性分析,结果表明WBC、NLR、NEFA、cTnI、MYO、CK、CKMB、LDH、HBDH与诊断分组成正相关(P<0.05)。结论ACS诊断中结合实验室心肌损伤指标和炎症指标的检查,在鉴别诊断以及临床上评估心血管疾病的发生风险都具有重要作用。

Objective This paper aims to investigate the level and the clinical significance of laboratory indicators in different diagnostic categories of acute coronary syndrome(ACS).Methods A total of 37 patients with ST-segment elevation myocar⁃dial infarction(STEMI group),64 patients with non-ST-segment elevation myocardial infarction(NSTEMI group),34 patients with unstable angina pectoris(UA group)and 50 healthy subjects(control group)were enrolled in this study.Myocar⁃dial injury markers and inflammatory indicator levels were detected and compared.Results The levels of WBC,NLR,cTnI,CK in the three groups with ACS were significantly higher than those in the control group,and the levels of NLR,cTnI,MYO,CK,CKMB,LDH,HBDH in the STEMI and NSTEMI groups were significantly higher than those in the UA group,with the differences statistically significant(P<0.05).ACS patients were grouped according to diagnosis,and Spearman correlation analysis showed that WBC,NLR,NEFA,cTnI,MYO,CK,CKMB,LDH,HBDH were positively correlated with diagnosis grouping(P<0.05).Conclusion In the diagnosis of ACS,the combination of laboratory myocardial injury and inflammation indicators plays an important role in differential diagnosis and clinical assessment of the risk of cardiovascular diseases.