血清Troponin I,CK-MBmass,Myoglobin在急性心肌梗塞诊断中的应用评价

为了解CTnI，CK－MBmass和Mb指标对急性心肌梗塞（AMI）早期诊断、后期监测及预后判断的临床意义，采用微粒子化学发光法，对20例AMI患者、24例不稳定心绞痛（UA）患者、17例骨骼肌损伤（SM）患者和19例健康者（对照组）进行血清CTnI，CK－MBmass和Mb的测定，并对AMI患者胸病发生3～5小时，8～14小时，20～24小时，72小时和7天共五个时段进行了测定。结果：AMI患者发病早期CTnI，CK－MBmass和Mb的阳性检出率分别为65％，70％，70％，CTnI在UA患者组和SM患者组中未检出。CTnI，CK－MBmass和Mb测定值含量在AMI组中明显高于UA组和SM组，AMI患者组CTnI分别是UA组和SM组的84倍和91.63倍，CK－Mbmass分别是该二组的8．82倍和4．67倍，Mb分别是该二组的11．57倍和2．25倍，AMI组与UA组和SM组比较，有显著性差异（P＜0．001）。AMI患者组中该三项指标的动态测定显示，在疾病发生早期（3～5小时）时，CTnI，CK－MBmass和Mb都有显著性升高，随时间延长而逐渐升高，高峰值期均在8～14小时段，72小时时Mb已基本回到正常。7天时血清中仍有CTnI的持续存在，但CK－MBmass已接近正常。以上显示，CTnI，CK－MBmass和Mb在早期诊断AMI时，都具有较高的敏感性，CTnI在AMI患者中的阳性检出率具有心肌特异性。

Third generation biosensor based on myoglobin-TiO_2/MWCNTs modified glassy carbon electrode

TiO2 nanoparticles were homogeneously coated on multi-walled carbon nanotubes by hydrothermal deposition, this nanocomposite may be a promising material for myoglobin immobilization in view of its high biocompatibility and large surface. The glassy carbon electrode modified with Mb-TiO2/MWCNTs films exhibited a pair of weU defined, stable and nearly reversible cycle voltammetric peaks. The electron transfer between Mb and electrode surface, Ks of 3.08 s^-1, was greatly facilitated in the TiO2/ MWCNTs film. The electrocatalytic reductions of hydrogen peroxide were studied, the apparent Michaelis-Menten constant is calculated to be 83.10 μmol/L, which shows a large catalytic activity of Mb in the TiO2/MWCNTs film to H2O2.

circMYO9A_006通过翻译蛋白MYO9A-208aa发挥抑制心肌细胞肥大的作用

目的:研究环状RNA MYO9A_006(circMYO9A_006)对心肌细胞肥大表型的调控作用及可能机制。方法:利用腺病毒介导在乳小鼠心室肌细胞(NMVCs)中过表达circMYO9A_006,并以腺病毒介导过表达同样带有绿色荧光蛋白标签的空载体为对照,检测NMVCs中心肌肥大相关蛋白β-肌球蛋白重链(β-MHC)、骨骼肌肌动蛋白α1(ACTA1)和心房钠尿肽(ANP)的表达。建立去氧肾上腺素(PE)诱导的乳大鼠心室肌细胞(NRVCs)肥大模型,通过鬼笔环肽染色检测过表达circMYO9A_006对NRVCs表面积的影响。双萤光素酶报告基因实验检测circMYO9A_006包含的潜在内部核糖体进入位点(IRES)的活性。通过Western blot实验检测circMYO9A_006翻译蛋白MYO9A-208aa及其在细胞内分布情况。分别制备circMYO9A_006-ORF(直接表达MYO9A-208aa)和circMYO9A_006-ATG-mut(不能表达MYO9A-208aa)重组病毒,以空载体病毒和circMYO9A_006重组病毒分别感染NRVCs,检测circMYO9A_006翻译蛋白MYO9A-208aa对心肌细胞肥大表型的特异调节作用。结果:利用腺病毒可在NMVCs中有效介导circMYO9A_006过表达。过表达circMYO9A_006可显著抑制NMVCs中心肌肥大相关蛋白的表达(P<0.01),并显著抑制PE诱导的NRVCs中心肌肥大相关蛋白的表达和细胞表面积的增加(P<0.05)。双萤光素酶报告基因实验结果提示,circMYO9A_006包含的2个IRES均具有活性。Western blot检测结果显示,在NRVCs中过表达circMYO9A_006可翻译预期大小为28 kD的MYO9A-208aa蛋白,并主要分布于细胞质中。过表达MYO9A-208aa和circMYO9A_006可一致地抑制NRVCs心肌肥大相关蛋白表达(P<0.01),并可逆转PE诱导的NRVCs肥大反应(P<0.05);而过表达circMYO9A_006-ATG-mut没有抑制NRVCs肥大的作用。结论:circMYO9A_006通过翻译蛋白MYO9A-208aa发挥抑制心肌细胞肥大的作用。

RIG-I,a novel DAMPs sensor for myoglobin,activates NF-κB/caspase-3 signaling in CS-AKI model

Background:Acute kidney injury(AKI)is the main life-threatening complication of crush syndrome(CS),and myoglobin is accepted as the main pathogenic factor.The pattern recognition receptor retinoicacid-inducible gene I(RIG-I)has been reported to exert anti-viral effects function in the innate immune response.However,it is not clear whether RIG-I plays a role in CS-AKI.The present research was carried out to explore the role of RIG-I in CS-AKI.Methods:Sprague-Dawley rats were randomly divided into two groups:the sham and CS groups(n=12).After administration of anesthesia,the double hind limbs of rats in the CS group were put under a pressure of 3 kg for 16 h to mimic crush conditions.The rats in both groups were denied access to food and water.Rats were sacrificed at 12 h or 36 h after pressure was relieved.The successful establishment of the CS-AKI model was confirmed by serum biochemical analysis and renal histological examination.In addition,RNA sequencing was performed on rat kidney tissue to identify molecular pathways involved in CS-AKI.Furthermore,NRK-52 E cells were treated with 200μmol/L ferrous myoglobin to mimic CS-AKI at the cellular level.The cells and cell supernatant samples were collected at 6 h or 24 h.Small interfering RNAs(siRNA)was used to knock down RIG-I expression.The relative expression levels of molecules involved in the RIG-I pathway in rat kidney or cells samples were measured by quantitative real-time PCR(qPCR),Western blotting analysis,and immunohistochemistry(IHC)staining.Tumor necrosis factor-α(TNF-α)was d etected by ELISA.Co-immunoprecipitation(Co-IP)assays were used to detect the interaction between RIG-I and myoglobin.Results:RNA sequencing of CS-AKI rat kidney tissue revealed that the different expression of RIG-I signaling pathway.qPCR,Western blotting,and IHC assays showed that RIG-I,nuclear factor kappa-B(NF-κB)P65,p-P65,and the a poptotic marker caspase-3 and cleaved caspase-3 were up-regulated in the CS group(P<0.05).However,the levels of interferon regulatory factor 3(IRF3),p-IRF3 and the antiviral factor interferon-beta(IFN-β)showed no significant c hanges between the sham and CS groups.Co-IP assays showed the interaction between RIG-I and myoglobin in the kidneys of the CS group.Depletion of RIG-I could alleviate the myoglobin induced expression of apoptosis-associated molecules via the NF-κB/caspase-3 axis.C onclusions:RIG-I is a novel damage-associated molecular patterns(DAMPs)sensor for myoglobin and participates in the NF-κB/caspase-3 signaling pathway in CS-AKI.In the development of CS-AKI,specific intervention in the RIG-I p athway might be a potential therapeutic strategy for CS-AKI.

Serum procalcitonin levels are associated with rhabdomyolysis following exertional heatstroke: an over 10-year intensive care survey

BACKGROUND:Heatstroke has become a common emergency event in hospitals.Procalcitonin(PCT)is used as a biomarker of infection in the emergency department(ED),but its role in rhabdomyolysis(RM)following exertional heatstroke(EHS)remains unclear.METHODS:A retrospective cohort study enrolled patients with EHS from the intensive care unit(ICU).We collected RM biomarkers,inflammation markers,critical disease scores at admission,24 h,48 h,and discharge,and 90-day mortality.Correlation analysis,linear regression and curve fi tting were used to identify the relationship between PCT and RM.RESULTS:A total of 162 patients were recruited and divided into RM(n=56)and non-RM(n=106)groups.PCT was positively correlated with myoglobin(Mb),acute hepatic injury,disseminated intravascular coagulation(DIC),Sequential Organ Failure Assessment(SOFA)score,and Acute Physiology and Chronic Health Evaluation II(APACHE II)score,with correlation coefficients of 0.214,0.237,0.285,0.454,and 0.368,respectively(all P<0.05).Interestingly,the results of curve fi tting revealed a nonlinear relationship between PCT and RM,and a two-piecewise linear regression model showed that PCT was related to RM with an odds ratio of 1.3 and a cut-off of<4.6 ng/mL.Survival analysis revealed that RM was associated with higher mortality compared to non-RM cases(P=0.0093).CONCLUSION:High serum PCT concentrations are associated with RM after EHS in critically ill patients.Elevated PCT concentrations should be interpreted cautiously in patients with EHS in the ED.

Direct Electrochemistry of Myoglobin in DDAB-Clay Composite Films

Ordered films were made by casting a mixture of aqueous dispersions of didodecyldimethylammonium bromide (DDAB)-clay composite and myoglobin (Mb) solution on pyrolytic graphite (PG) electrodes. The Mb-DDAB-clay film electrodes showed stable and reversible cyclic voltammetric responses in buffers and can catalyze the reduction of id (TCA).

Myoglobin as Mimetic Enzyme and Its Analytical Application in Determination of H_2O_2

The characteristic of Myoglobin as mimetic enzyme was studied and applied in the determination of HeO2 with o-phenylenediamine as substrate. The absorbanee obtained at 40 ℃ was found to be proportional to the concentration of H2O2 in the range of 2.0×10^-5- 2.0×10^-7 mol/L, with a correlation coefficient of 0.999 1. The proposed meth od is simple and highly sensitive to a detection limit of 2.7 × 10^-8 mol/L. The relative standard deviations were within 5% for the determination of different concentrations of H2O2. Satisfied results were obtained in the determination of H2O2 in rainwater by this method, and the recoveries were at the range of 97.2%-105.4%.

Expression of Myoglobin in the Urine of Cocaine Users

Background: The possibility exists that cocaine use in the absence of frank clinical presentation of acute cardiac events may be associated with subclinical injury including the release of myoglobin which is a nonspecific marker for cardiac and skeletal muscle damage. Objectives: This investigation examined urine specimens for potential differences between cocaine use and the expression of myoglobin (a marker associated with cardiovascular damage, inflammation and oxidative stress). Methods:40 urine specimens were assayed for cocaine metabolites, creatinine, total protein (BSA) and myoglobin using ELISA and colorimetry. Results: We observed significant differences between male control and male cocaine positive urines for myoglobin. Interestingly, there was no statistically significant difference in females between control and cocaine positive urines. Conclusion: Differences in the urinary expression of myoglobin may be important in evaluating the gender based effects of cocaine use and may have potential clinical applications which may be related to gender differences in signs and symptoms of cocaine toxicity.

Myo1E在胰腺导管腺癌组织中的表达及临床意义

目的:分析肌球蛋白1E(Myo1E)在胰腺导管腺癌(PDAC)组织中的表达及临床意义。方法:用在线癌症基因组图谱数据库中PDAC的二代测序数据,分析Myo1E mRNA在PDAC组织中的表达水平,与患者预后和免疫检查点的关系;用PDAC组织芯片,经免疫组化染色,统计分析Myo1E蛋白表达的临床意义以及和免疫检查点PD-L1的相关性。结果:Myo1E mRNA和蛋白在PDAC组织中的表达明显高于良性胰腺组织,且与患者预后差有关;Myo1E蛋白表达与肿瘤直径(P=0.004)、淋巴结转移(P<0.001)、侵犯周围组织(P=0.008)、临床分期(P<0.001)相关;生存分析显示,Myo1E蛋白在PDAC组织中表达,是患者预后的独立风险因素(HR:1.686,P=0.010);且与PD-L1的表达具有线性正相关(r=0.388,P<0.001)。结论:PDAC组织中Myo1E是患者预后的独立风险因素,或可成为潜在的免疫治疗靶点。

急性心肌梗死患者血清MYO、cTnI、FIB的表达水平及临床意义

目的探究肌红蛋白(MYO)、心肌肌钙蛋白I(cTnI)、纤维蛋白原(FIB)在急性心肌梗死患者血清中的表达水平及临床意义。方法收集河南科技大学第二附属医院2021年3月至2023年3月收治的86例急性心肌梗死患者临床资料作为观察组,另外收集同时期入院检查的56例非急性心肌梗死者临床资料作为对照组,比较两组MYO、cTnⅠ、FIB水平,以及三者对急性心肌梗死的预测价值。结果两组年龄、性别、体质量指数、吸烟、饮酒、高血压、冠心病、糖尿病、高血脂差异无统计学意义(P>0.05)。观察组MYO、cTnⅠ、FIB水平均高于对照组,差异有统计学意义(P<0.05)。MYO、cTnⅠ、FIB表达水平随冠状动脉狭窄程度的加重而增加,不同冠状动脉狭窄程度的MYO、cTnI、FIB水平比较,差异有统计学意义(P<0.05)。MYO、cTnⅠ、FIB以及三者联合的AUC面积分别为0.995、0.988、0.977、0.999,三者联合的AUC面积最大,灵敏度相对单一指标较高,预测效能相对较好。结论MYO、cTnⅠ、FIB三者联合对急性心肌梗死有良好的预测价值,可作为临床诊断急性心肌梗死的辅助工具。

Availability of Myoglobin as a Molecular Marker for Phylogenetic Relationships of Fish

In order to elucidate the phylogenetic relationship of fish, DNA and deduced amino acid sequences of myoglobin （Mb） were used for the phylogenetic analyses based on different approaches, namely, maximum likelihood （ML）, neighbor joining （NJ）, unweighted pair group method with arithmetic means （UPGMA） and maximum parsimony （MP） methods in comparison with the conventional molecular markers, mitochondrial cytochrome b （cyt-b） and cytochrome c oxidase subunit I （COI）. The phylogenetic trees drawn based on Mb sequences were similar to those by the traditional classification based on the other molecular markers. The primary and secondary structures, as well as the modeled tertiary structures of Mbs were similar to each other, but were clearly distinguishable among those species. Such differences in structure would be associated with adaptation of Mb molecule to the physiological conditions of each species. These results suggest that Mb can be a molecular marker for the phylogenetic relationship of fish.

hs-CRP、cTnI、Myo及CK-MB检测在急性心肌梗死诊断中的临床应用价值

目的 探讨超敏C反应蛋白(Hypersensitive C-reactive Protein, hs-CRP)、肌钙蛋白(Cardiac Troponin I,cTnI)、肌红蛋白(Myoglobin, Myo)、肌酸激酶同工酶(Creatine Kinase Isoenzymes-MB, CK-MB)联合检测诊断急性心肌梗死的价值。方法 选取2020年2月—2023年5月苏州市吴中人民医院收治的75例急性心肌梗死者与75例健康体检者,设为观察组与对照组,比较两组hs-CRP、cTnI、Myo及CK-MB水平,分析联合检测与心梗三项及hs-CRP检测的诊断效能。结果 观察组hs-CRP、cTnI、Myo、CK-MB均高于对照组,差异有统计学意义(P均<0.05)。联合检测诊断准确度97.33%、灵敏度98.67%,高于心梗三项的92.00%、86.67%与hs-CRP的89.33%、80.00%,差异有统计学意义(χ^(2)=6.125、7.111,12.000、14.000,P均<0.05)。结论 急性心肌梗死患者hs-CRP与心梗三项检测值明显升高,联合检测能提高对急性心肌梗死的诊断效能。

MYO5A 35号外显子跳跃对头颈鳞状细胞癌患者的预后相关研究

目的:探讨MYO5A基因在头颈鳞状细胞癌(head and neck squamous cell carcinoma,HNSCC)中作为预后分子标志物的潜力。方法:从TCGA数据库下载HNSCC队列的RNA-Seq数据及相应的临床数据,单变量Cox回归分析MYO5A与患者预后之间的关系。从TCGA SpliceSeq数据库下载MYO5A基因的可变剪接类型,根据剪接百分比(percent spliced in,PSI)值识别差异性表达的MYO5A基因的可变剪接,并分析其与HNSCC患者预后的相关性。最后通过RT-PCR和Sanger测序在细胞系及徐州医科大学附属医院临床样本中进一步验证。结果:MYO5A基因在HNSCC队列中显著高表达,但MYO5A基因整体表达水平并不能作为独立的HNSCC预后风险指标。MYO5A 35号外显子跳跃在HNSCC中发生频率增加,且与预后密切相关。MYO5A 35号外显子跳跃在细胞系及临床样本中均得到了验证。结论:MYO5A 35号外显子跳跃而不是MYO5A基因整体表达水平可作为HNSCC预后独立的分子标志物。

Inflammatory myofibroblastic tumor from molecular diagnostics to current treatment

Inflammatory myofibroblastic tumor(IMT)is a rare neoplasm with intermediate malignancy characterized by a propensity for recurrence but a low metastatic rate.Diagnostic challenges arise from the diverse pathological presentation,variable symptomatology,and lack of different imaging features.However,IMT is identified by the fusion of the anaplastic lymphoma kinase(ALK)gene,which is present in approximately 70%of cases,with various fusion partners,including ran-binding protein 2(RANBP2),which allows confirmation of the diagnosis.While surgery is the preferred approach for localized tumors,the optimal long-term treatment for advanced or metastatic disease is difficult to define.Targeted therapies are crucial for achieving sustained response to treatment within the context of genetic alteration in IMT.Crizotinib,an ALK tyrosine kinase inhibitor(TKI),was officially approved by the US Food and Drug Administration(FDA)in 2020 to treat IMT with ALK rearrangement.However,most patients face resistance and disease progression,requiring consideration of sequential treatments.Combining radiotherapy with targeted therapy appears to be beneficial in this indication.Early promising results have also been achieved with immunotherapy,indicating potential for combined therapy approaches.However,defined recommendations are still lacking.This review analyzes the available research on IMT,including genetic disorders and their impact on the course of the disease,data on the latest targeted therapy regimens and the possibility of developing immunotherapy in this indication,as well as summarizing general knowledge about prognostic and predictive factors,also in terms of resistance to systemic therapy.

Myo、Gas6、SOX9 mRNA在AMI患者中的表达意义及在PCI术后联合检测对预后的评估价值

目的探讨肌红蛋白(Myo)、生长停滞特异性蛋白6(Gas6)、SRY相关高迁移率族蛋白9(SOX9)在急性心肌梗死(AMI)患者中的表达意义,同时将患者预后经皮冠状动脉介入治疗(PCI)联合检测评估价值。方法选择2020年1月至2021年6月期间接收的AMI患者,共计166例,并将其纳入研究组,同时选取健康志愿者,将其纳入对照组,共计90例。酶联免疫吸附法测定血清Myo、Gas6水平,SOX9 mRNA分离试剂盒提取RNA检测;根据患者住院期间是否发生心血管不良事件(MACCE)将研究组患者分为MACCE组和非MACCE组;对比研究组和对照组Myo、Gas6、SOX9 mRNA表达情况;对比Myo、Gas6、SOX9 mRNA在AMI患者PCI术前后中表达情况;单因素/多因素分析MACCE组和非MACCE组资料临床差异;分析Myo、Gas6、SOX9 mRNA联合对AMI预后评估价值。结果相较于对照组,研究组Myo和Gas6明显较高,SOX9 mRNA表达明显较低(P<0.05);术后,研究组患者Myo、Gas6表达明显降低,SOX9 mRNA明显升高(P<0.05);MACCE组Myo和Gas6明显高于非MACCE组,SOX9 mRNA表达明显低于非MACCE组(P<0.05)。Logistic回归模型结果显示年龄大、术后出血、Myo和Gas6表达高、SOX9 mRNA表达低是影响经PCI治疗AMI患者发生MACCE独立危险因素(P<0.05)。Myo、Gas6、SOX9 mRNA联合评估AMI预后受试者工作特征(ROC)曲线下面积为0.936,具有较高的特异度以及敏感度,且显著高于单独Myo、Gas6、SOX9 mRNA检测ROC曲线下面积为0.706、0.696和0.711(Z=2.261,P<0.05)。结论对于AMI患者而言,其Myo和Gas6表达明显较高,SOX9 mRNA表达明显降低,而经PCI术治疗可有效改善患者Myo、Gas6和SOX9 mRNA水平;三者联合对PCI术后发生MACCE具有明显评估作用,尽早为患者提供诊疗方案,值得在临床推广应用。

Exertional Rhabdomyolysis Induced Acute Kidney Injury: A Case Report and Literature Review

Background: The exRML (exertional rhabdomyolysis) is a pathophysiologic condition of skeletal muscle cell damage and breakdown associated with high intensity or prolonged exercise, normal exercise under extreme circumstances, or sudden and excessive skeletal muscle contraction. It may manifest from the increase in CK (creatine kinase) or MYO (myoglobin), a protein that can cause life-threatening injury to the kidney (AKI, acute kidney injury), and may or may not be associated with myoglobinuria. Here, we presented a case of exRML with AKI, and then reviewed the related reports. Vigorous hydration, sodium bicarbonate and furosemide are key treatments. Aim: To examine an elderly patient with exRML induced AKI and the key treatment process. Case summary: A 61-year-old man left our hospital without permission after his admission and has been walking for almost 30 kms with no water and food intake, then was diagnosed exRML and exRML induced AKI with an obvious elevation of CK, MYO and decrease of eGFR (estimated glomerular filtration rate) after coming back, and was treated with vigorous hydration, loop diuresis, sodium bicarbonate, prostaglandin and Shenkang injection. After vigorous resuscitation, the patient’s renal function, CK and MYO returned normal. Conclusions: The exRML can cause serious complications such as AKI and death. Delayed diagnosis can be critical;therefore, manner of time should be taken to achieve a favorable prognosis.

慢性心力衰竭患者血清MYO、cTnI、CK-MB水平变化及对疗效的预测价值

目的:探讨慢性心力衰竭(CHF)患者血清肌红蛋白(MYO)、肌钙蛋白Ⅰ(cTnI)、肌酸激酶同工酶(CK-MB)水平变化及与心功能的相关性,并分析其对疗效的预测价值。方法:选取2021年7月—2023年7月某院收治的92例CHF患者作为研究组,另选取同期健康体检者92例作为对照组。比较2组血清MYO、cTnI、CK-MB水平,分析血清MYO、cTnI、CK-MB水平与心功能分级相关性;比较不同疗效患者血清MYO、cTnI、CK-MB水平,分析其水平与CHF患者疗效的关系,绘制受试者工作曲线(ROC),评价血清MYO、cTnI、CK-MB水平对CHF患者疗效的预测价值。结果:研究组血清MYO、cTnI、CK-MB水平高于对照组,差异有统计学意义(P<0.05)。随着NYHA心功能分级增加,血清MYO、cTnI、CK-MB水平呈上升趋势(P<0.05);Spearman相关分析显示,血清MYO、cTnI、CK-MB水平与NYHA心功能分级呈正相关关系(r=0.448、0.462、0.537,P均<0.05)。无效者血清MYO、cTnI、CK-MB水平高于有效者(P<0.05);多因素Logistic回归分析显示,治疗7 d后血清MYO、cTnI、CK-MB水平均为CHF患者疗效的影响因素(P<0.05);血清MYO、cTnI、CK-MB水平对CHF患者疗效预测价值的AUC分别为0.801、0.769、0.829,联合预测的AUC为0.963。结论:CHF患者血清MYO、cTnI、CK-MB水平升高,且与心功能分级呈正相关关系,联合检测其水平对疗效具有一定预测价值,可作为预测疗效的潜在指标。

血清BNP、MYO、cTnI诊断急性心肌梗死和预测主要心血管不良事件的价值

目的探究血清脑钠肽(BNP)、肌红蛋白(MYO)、肌钙蛋白I(cTnI)诊断急性心肌梗死(AMI)和预测患者预后的临床价值。方法回顾性分析2021年9月至2022年9月漯河市中医院收治的252例患者的临床资料,将其中168例AMI患者纳入AMI组,84例不稳定心绞痛患者纳入对照组,比较两组患者的血清BNP、MYO、cTnI水平,采用受试者工作特征(ROC)曲线分析血清BNP、MYO、cTnI水平诊断AMI的价值,对AMI组患者随访12个月,根据主要心血管不良事件(MACE)发生情况分为发生MACE组45例和未发生MACE组123例,采用二元Logistic回归分析MACE发生的危险因素,并通过ROC曲线分析血清BNP、MYO、cTnI水平预测MACE的价值。结果AMI组患者的血清BNP、MYO、cTnI水平分别为(164.93±51.85)ng/L、(88.28±23.63)μg/L、(4.75±1.38)ng/mL,明显高于对照组的(97.11±25.89)ng/L、(57.38±15.33)μg/L、(2.49±0.65)ng/mL,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,血清BNP、MYO、cTnI水平诊断AMI的曲线下面积(AUC)分别为0.803、0.801、0.934,灵敏度/特异度分别为100.0%/50.0%、51.2%/100.0%、90.5%/89.3%;二元Logistic回归分析结果显示,年龄(≥60岁)、糖尿病史、发病至治疗时间、BNP、MYO、cTnI均是MACE的危险因素(P<0.05);ROC曲线分析结果显示,血清BNP、MYO、cTnI水平预测MACE的AUC分别为0.826、0.908、0.866,而联合数据预测MACE的AUC为0.964,灵敏度、特异度分别为91.9%、100.0%。结论血清BNP、MYO、cTnI水平可作为AMI临床诊断与预后预测的有效指标,联合检测预测预后价值更高。

hs-cTnI、Myo、CK-MB联合检测在急性心肌梗死中的诊断价值

目的:探讨高敏心肌肌钙蛋白I(hs-cTnI)、肌红蛋白(Myo)及肌酸激酶同工酶(CK-MB)联合检测在急性心肌梗死中的诊断价值。方法:选取2021年6月—2022年6月仁怀市人民医院收治的100例急性心肌梗死患者作为观察组,另选取同期100例住院患者作为对照组。两组均检测hs-cTnI、Myo、CK-MB水平。比较两组hs-cTnI、Myo、CK-MB水平,分析hs-cTnI、Myo、CK-MB及三者联合检测在急性心肌梗死中的诊断价值。结果:观察组hs-cTnI、Myo、CK-MB水平均高于对照组,差异有统计学意义(P<0.05)。绘制受试者工作特征(ROC)曲线显示,hs-cTnI、Myo、CK-MB联合检测诊断急性心肌梗死的曲线下面积(AUC)最高。结论:hs-cTnI、Myo、CK-MB在急性心肌梗死诊断中具有一定价值,联合检测价值最高,有助于患者尽早开展针对性治疗,以改善预后。

NT-pro BNP、MYO、CK-MB水平预测慢性肾衰合并心衰患者预后的价值分析

探究NT-proBNP、MYO、CK-MB水平预测慢性肾衰合并心衰患者预后的价值。方法:选取2022年01月~2023年01月84例慢性肾衰合并心衰患者,分为预后良好组和预后不良组,分别为63例和21例,测定所有受试者N-末端脑钠肽前体、肌红蛋白及肌酸激酶同工酶水平。结果:(1)单因素分析结果:年龄、CKD分期、心衰分期、有无合并症、病程、NT-proBNP、MYO、CK-MB与慢性肾衰合并心衰预后有相关性(P<0.05);(2)多因素分析:年龄≥60岁、CKD4/5期、心衰C、D期、有合并症、病程≥3年、NT-proBNP、MYO、CK-MB水平是造成慢性肾衰合并心衰预后不良的危险因素。结论:NT-proBNP、MYO、CK-MB具有预测慢性肾衰合并心衰患者预后的价值,临床意义重大。