hs-CRP、NT-proBNP及NAR对急性冠状动脉综合征患者诊断价值分析

Analysis of the Value of hs-CRP, NT-proBNP and NAR Indexes in the Diagnosis of ACS Patients

目的 探讨超敏C反应蛋白(hs-CRP)、氨基末端脑钠肽前体(NT-proBNP)及中性粒细胞与白蛋白比值(NAR)对急性冠状动脉综合征(ACS)患者的诊断价值。方法 选取2020年6月—2022年9月收治的ACS 71例作为研究组,同期健康体检者56例作为对照组,并依照不同疾病类型和血管病变支数将研究组分为ST段抬高型心肌梗死(STEMI)组、非ST段抬高型心肌梗死(NSTEMI)组、不稳定型心绞痛(UAP)组及单支、双支、多支病变组各3个亚组。比较研究组与对照组、不同疾病类型和血管病变支数各3个亚组hs-CRP、NT-proBNP及NAR,探讨hs-CRP、NT-proBNP及NAR单独或联合对ACS的诊断价值。结果 研究组hs-CRP、NT-proBNP及NAR均高于对照组;STEMI组、NSTEMI组和UAP组hs-CRP、NT-proBNP及NAR逐渐降低,单支、双支和多支病变组hs-CRP、NT-proBNP及NAR逐渐升高(P<0.05)。受试者工作特征曲线分析显示,hs-CRP、NT-proBNP和NAR单独或联合诊断ACS的曲线下面积分别为0.820、0.815、0.883及0.914,三者联合诊断ACS的曲线下面积高于单独诊断(P<0.05,P<0.01)。结论 hs-CRP、NT-proBNP及NAR三者联合对ACS的诊断价值较高。

Objective To investigate the value of hypersensitive C reactive protein(hs-CRP),N-terminal pro-B type natriuretic peptide(NT-proBNP)and neutrophil to albumin ratio(NAR)indexes in the diagnosis of ACS patients.Methods In total,71 ACS patients admitted from June 2020 to September 2022 were selected,and 56 healthy people undergoing physical examination during the same period were enrolled as the control group.According to different types of disease and numbers of vascular lesions,the research group was divided into three subgroups:ST segment elevation myocardial infarction(STEMI)subgroup,NSTEMI subgroup,unstable angina pectoris(UAP)subgroup,as well as single vascular lesion subgroup,double vascular lesion subgroup,and multi-vascular lesion subgroup.hs-CRP,NT-proBNP,and NAR were compared between the research group and the control group,between subgroups with different types of disease,and between subgroups with different numbers of vascular lesions.The value of hs-CRP,NT-proBNP,and NAR alone or in combination for the diagnosis of ACS was explored.Results The levels of hs-CRP,NT-proBNP,and NAR in the research group were higher than those in the control group(P<0.05).The levels of hs-CRP,NT-proBNP,and NAR gradually decreased in the STEMI,NSTEMI,and UAP subgroups,which gradually increased in single vascular lesion subgroup,double vascular lesion subgroup,and multi-vascular lesion subgroup(P<0.05).The receiver operating characteristic(ROC)curve results showed that the area under the ROC curve(AUC)of hs-CRP,NT-proBNP,and NAR alone and in combination in diagnosing AIS was 0.820,0.815,0.883,and 0.914,respectively,and the AUC of the three indicators in combination was higher than that of single indicator alone(P<0.05,P<0.01).Conclusion The combined detection of hs-CRP,NT-proBNP and NAR has greater value in the diagnosis of ACS.