心肌酶谱与心脏彩超在急性心肌梗死中的诊断价值

Diagnostic value of myocardial zymogram and cardiac color ultrasound in acute myocardial infarction

目的研究心肌酶谱与超声心动图在急性心肌梗死中的诊断价值。方法选择2021年1月至2023年2月来聊城市第三人民医院治疗的100例急性心肌梗死患者作为观察组,另择选同期来聊城市第三人民医院体检的83例健康者作为对照组。观察组男61例,女39例,年龄(56.47±8.65)岁;对照组男56例,女27例,年龄(56.58±9.02)岁。对比两组研究对象性别、年龄、职业等一般资料,对比两组研究对象左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、心肌酶指标。采用独立样本t检验、χ^(2)检验、Pearson相关性分析。结果两组研究对象体质量指数、年龄、性别、吸烟史、饮酒史、婚姻状况、职业、居住地址、收缩压(SBP)及血清三酰甘油(TG)、空腹血糖(FPG)水平进行比较,差异均无统计学意义(均P>0.05);观察组LVEF低于对照组[(55.48±3.16)%比(65.42±3.37)%],差异有统计学意义(P<0.05),观察组LVEDD高于对照组[(53.85±7.22)mm比(47.20±2.83)mm],差异有统计学意义(P<0.05);两组研究对象血清乳酸脱氢酶(LDH)、同型半胱氨酸(HCY)水平比较,差异均无统计学意义(均P>0.05),观察组血清肌酸激酶(CK)及肌酸激酶同工酶(CK-MB)水平均较对照组更高,差异均有统计学意义(均P<0.05);Pearson相关性分析显示:急性心肌梗死患者LVEF与CK-MB呈负相关(P<0.05),LVEDD与CK-MB呈正相关(P<0.05);LVEF、LVEDD、CK-MB及三项联合诊断急性心肌梗死的曲线下面积分别为0.917、0.800、0.929、0.953,灵敏度分别为0.861、0.816、0.893、0.904,特异度分别为0.825、0.889、0.795、0.764。结论急性心肌梗死患者LVEF及血清CK、CK-MB水平降低,LVEDD升高,LVEF、LVEDD、CK-MB联合诊断急性心肌梗死比单独诊断更有优势,可获得较好的诊断效能。

Objective To study the diagnostic value of myocardial zymogram and echocardiography in acute myocardial infarction.Methods A total of 100 patients with acute myocardial infarction who came to the Third People's Hospital of Liaocheng City from January 2021 to February 2023 were selected as the observation group,and 83 healthy subjects who came to our hospital for physical examination during the same period were selected as the control group.In the observation group,there were 61 males and 39 females,aged(56.47±8.65)years;in the control group,there were 56 males and 27 females,aged(56.58±9.02)years.The general data such as gender,age,and occupation were compared between the two groups.The left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),and myocardial enzyme indexes were compared between the two groups.Independent sample t test,χ^(2) test,and Pearson correlation analysis were used.Results There were no statistically significant differences in the body mass index,age,gender,smoking history,drinking history,marital status,occupation,residence address,systolic blood pressure(SBP),and serum triglyceride(TG)and fasting blood glucose(FPG)levels between the two groups(all P>0.05).The LVEF of the observation group was lower than that of the control group[(55.48±3.16)%vs.(65.42±3.37)%],while the LVEDD of the observation group was higher than that of the control group[(53.85±7.22)mm vs.(47.20±2.83)mm],with statistically significant differences(both P<0.05).There were no statistically significant differences in the serum lactate dehydrogenase(LDH)and homocysteine(HCY)levels between the two groups(both P>0.05),while the serum creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)levels in the observation group were higher than those in the control group,with statistically significant differences(both P<0.05).Pearson correlation analysis showed that LVEF was negatively correlated with CK-MB in patients with acute myocardial infarction(P<0.05),while LVEDD was positively correlated with CK-MB(P<0.05).The areas under the curves of LVEF,LVEDD,CK-MB,and their combination in the diagnosis of acute myocardial infarction were 0.917,0.800,0.929,and 0.953,the sensitivities were 0.861,0.816,0.893,and 0.904,respectively,and the specificities were 0.825,0.889,0.795,and 0.764,respectively.Conclusions The levels of LVEF and serum CK and CK-MB in patients with acute myocardial infarction decrease,while the LVEDD increases.The combination of LVEF,LVEDD,and CK-MB in the diagnosis of acute myocardial infarction is more advantageous than that of single diagnosis,and better diagnostic efficacy can be obtained.