肌酸激酶同工酶MB、肌钙蛋白Ⅰ、氨基末端脑钠肽前体对非ST段抬高心肌梗死的诊断价值

Diagnostic value of creatine kinase isoenzyme-MB,cardiac troponin Ⅰ,and N-terminal pro-brain natriuretic peptide in non-ST segment elevation myocardial infarction

目的探讨肌酸激酶同工酶MB(CK-MB)、肌钙蛋白Ⅰ(cTnI)、氨基末端脑钠肽前体(NT-pro BNP)对非ST段抬高心肌梗死的诊断价值。方法选取江苏省如皋市人民医院2020年6月至2022年1月收治的120例非ST段抬高心肌梗死患者作为观察组,另选取同期120例不稳定型心绞痛患者作为对照组。观察非ST段抬高心肌梗死患者的心电图特征;比较两组CK-MB、cTnI和NT-pro BNP水平;分析非ST段抬高心肌梗死发生的影响因素;采用受试者操作特征曲线分析CK-MB、cTnI、NT-pro BNP诊断非ST段抬高心肌梗死的诊断效能。结果120例非ST段抬高心肌梗死患者中,ST段持续压低53例、ST段压低动态衍变67例。观察组血清CK-MB、cTnI、NT-pro BNP水平高于对照组(P<0.05)。CK-MB、cTnI及NT-pro BNP是发生非ST段抬高心肌梗死的危险因素(OR=3.515、4.683、3.577,P<0.05)。CK-MB、cTnI、NT-pro BNP单一及联合诊断非ST段抬高心肌梗死的曲线下面积分别为0.750(95%CI:0.649~0.851)、0.748(95%CI:0.649~0.847)、0.731(95%CI:0.631~0.832)、0.827(95%CI:0.739~0.915)。结论CK-MB、cTnI、NT-pro BNP可用于辅助诊断非ST段抬高心肌梗死,且诊断效能较高。

Objective To explore the diagnostic value of creatine kinase isoenzyme-MB(CK-MB),cardiac troponin Ⅰ(cTnI),and N-terminal pro-brain natriuretic peptide precursor(NT-pro BNP)in non-ST segment elevation myocardial infarction.Methods A total of 120 patients with non-ST segment elevation myocardial infarction admitted to Rugao People’s Hospital of Jiangsu Province from June 2020 to January 2022 were selected as observation group,and another 120 patients with unstable angina pectoris were selected as control group.The electrocardiogram characteristics of patients with non-ST segment elevation myocardial infarction were observed;the levels of CK-MB,cTnI,and NT-pro BNP were compared between two groups;the factors influencing the occurrence of non-ST elevation myocardial infarction were analyzed;and receiver operating characteristic curve was used to analyze the diagnostic efficacy of CK-MB,cTnI,and NT-pro BNP in the diagnosis of non-ST elevation myocardial infarction.Results In 120 patients with non-ST segment elevation myocardial infarction,ST segment depression was sustained in 53 cases and dynamic ST segment depression was developed in 67 cases.The serum levels of CK-MB,cTnI,and NT-pro BNP in observation group were higher than those in control group(P<0.05).CK-MB,cTnI,and NT-pro BNP were the risk factors for non-ST elevation myocardial infarction(OR=3.515,4.683,3.577,P<0.05).The area under the curve of CK-MB,cTnI,and NT-pro BNP for single and combined diagnosis of acute non-ST elevation myocardial infarction were 0.750(95%CI:0.649-0.851),0.748(95%CI:0.649-0.847),0.731(95%CI:0.631-0.832),and 0.827(95%CI:0.739-0.915)respectively.Conclusion CK-MB,cTnI,and NT-pro BNP can be used to assist in the diagnosis of non-ST elevation myocardial infarction,and the diagnostic efficiency is high.