摘要
目的分析联合检测血液D-二聚体(D-D),N末端B型脑钠肽(NT-proBNP)和超敏肌钙蛋白Ⅰ(TropⅠ)三项指标在急性胸痛患者早期诊断中的鉴别意义。方法以急性胸痛、胸闷、呼吸困难等为主要表现的急诊患者109例,入院后立即静脉采血检测,经确诊分为急性心肌梗死(AMI)组58例、急性肺动脉梗死(APE)组28例和急性主动脉夹层(AAD)组23例,同时随机分为联合检查组和常规检查组;另选同期健康体检人员101例作为对照组。分别比较三组患者基本资料,D-D,NT-proBNP和TropⅠ水平值,联合检查组和常规检查组入院初步诊断准确率差异。结果 AMI,APE和AAD三组间年龄、吸烟、高血压史、糖尿病史、高脂血症和血CK-MB差异均具有统计学意义(P<0.05或P<0.001);D-D,NT-proBNP,TropⅠ值与对照组比较差异均有统计学显著性意义(P<0.05)。对照组D-D值与AMI组比较,APE组和AAD组比较差异均有统计学显著性意义(P<0.05),NT-proBNP值与APE组比较,AMI组和AAD组比较差异有统计学显著性意义(P<0.05);TropⅠ值与AMI组比较,APE组和AAD组比较差异有统计学显著性意义(P<0.05);联合检测D-D,NTproBNP,TropⅠ三种标志物并结合临床表现及其他影像学检查在急性胸痛患者中初步诊断准确率可达95.4%,而常规的心电图、血细胞检测、电解质及心肌酶谱等诊断胸痛患者,其准确率仅为89.0%,两者间差异有统计学显著性意义(P<0.05)。结论对于急性胸痛症患者,联合检测D-D,NT-proBNP和TropⅠ并结合病史能够有效的帮助医生进行快速、准确地作出早期诊断,从而减少误诊,有效地提高患者生存率,对挽救生命具有重要意义。
Objective To discuss the diagnostic value of combined detection of D-D,NT-proBNP and TropⅠ in the early diagnosis of acute chest pain.Methods 109 emergency patients with acute chest pain,dyspnea,as the main performance of the cases,detection of venous blood immediately after admission,were diagnosed and divided into 58 cases of acute myocardial infarction（AMI）group,28 cases of acute pulmonary artery infarction（APE）group and 23 cases of acute aortic dissection（AAD）group,and randomly divided the joint inspection group and routine group.Over the same period,101 healthy persons were selected as control group.The basic data of the three groups were compared,and the levels of D-D,NT-proBNP and TropⅠ were compared.The accuracy rate of primary diagnosis was different in the joint inspection group and the routine examination group.Results AMI,APE and AAD between the three groups in age,smoking,hypertension,diabetes,hyperlipidemia,blood CK-MB differences were statistically significant（P〈0.05 or P〈0.001）.D-D,NT-proBNP and TropⅠ value compared with the control group there was significant difference（P〈0.05）.The value of D-D and AMI group compared with APE group and AAD group there was significantly different（P〈0.05）,compared with the APE group NT-proBNP,AMI group and AAD group there was significant difference（P〈0.05）,and compared with the AMI group of Trop value,APE group and AAD group,there was significant difference（P〈0.05）.Combined detection of D-D,NT-proBNP and TropⅠ,and examination combined with clinical manifestations and other images in patients with acute chest pain,the initial diagnosis accuracy rate was 95.4%,while the conventional electrocardiogram,blood electrolytes and myocardial enzymes in diagnosis of chest pain patients,the accuracy rate was only 89%.There were significant differences between the two groups（P〈0.05）.Conclusion For patients with acute chest pain,combined detection of D-D,NT-proBNP and TropⅠ combined with medical history can help doctors to make early and accurate diagnosis quickly and accurately,so as to reduce misdiagnosis,effectively improve the survival rate of patients,and is of great significance for saving lives.
作者
戴学庆
涂秀
纪泽森
DAI Xue-qing a;TU Xiu a;JI Ze-sen b(a.Department of Clinical Laborator;b.Department of Cardiology,Jinhu County People＇ s Hospital in Jiangsu Province,Jiangsu Jinhu 211600,China)
出处
《现代检验医学杂志》
CAS
2018年第4期115-118,共4页
Journal of Modern Laboratory Medicine
