摘要
目的探讨心肌肌钙蛋白I(cTnI)、超敏C-反应蛋白(hs-CRP)、白细胞介素-17(IL-17)与和肽素联合检测在诊断急性心肌梗死(AMI)中的价值。方法选取AMI患者120例为观察组,同期健康体检者100例为对照组,比较不同时间点受试者血清cTnI、hs-CRP、IL-17及和肽素水平;绘制受试者特征工作(ROC)曲线,评估cTnI、hs-CRP、IL-17、和肽素及联合应用对AMI的诊断价值。结果两组血清cTnI、hs-CRP、IL-17、和肽素水平在0、4、6 h均有明显差异(P<0.05);观察组血清cTnI、hs-CRP、IL-17、和肽素水平呈逐渐上升趋势(P<0.05);不同时间点对照组血清CTnI、hs-CRP、IL-17、和肽素水平差异无统计学意义(P>0.05)。观察组0 h血清cTnI与hs-CRP、IL-17水平呈正相关,血清hs-CRP与IL-17、和肽素水平呈正相关,血清IL-17与和肽素水平呈正相关(P<0.05)。cTnI、hs-CRP、IL-17、和肽素及联合检测的曲线下面积(AUC)分别为0.743、0.781、0.692、0.836和0.869,联合检测的AUC值明显大于单独指标,且联合检测对AMI的诊断敏感度和特异度最高。结论血清cTnI、hs-CRP、IL-17、和肽素水平在AMI患者中明显升高,多种指标可能协同促进共同参与AMI进程,联合检测可提高早期AMI临床诊断的敏感度和特异度,对AMI诊断具有较好的应用价值。
Objective To explore the diagnostic value of combined detection of cardiac troponin I(cTnI),hypersensitive C-reactive protein(hs-CRP),interleukin-17(IL-17)and copeptin for acute myocardial infarction(AMI).Methods A total of 120 AMI patients were enrolled as observation group,while another 100 healthy volunteers who underwent physical examination during the same period were enrolled as control group.The changes in levels of serum cTnI,hs-CRP,IL-17 and copeptin were compared among all objects.Receiver operating characteristic(ROC)curves were drawn to evaluate the diagnostic value of cTnI,hs-CRP,IL-17 and copeptin alone,and their combination for AMI.Results Levels of serum cTnI,hs-CRP,IL-17 and copeptin were significantly different in both groups at 0 h,4 h and 6 h(P<0.05).The levels of serum cTnI,hs-CRP,IL-17 and copeptin in the observation group were gradually increased(P<0.05),while the differences in the above indexes were not significantly different in the control group at different time points(P>0.05).In the observation group,serum cTnI was positively correlated with levels of hs-CRP and IL-17 at 0 h(P<0.05).The serum hs-CRP was positively correlated with levels of IL-17 and copeptin(P<0.05).The serum IL-17 was positively correlated with copeptin level(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)values of cTnI,hs-CRP,IL-17 and copeptin alone,and their combination detection were 0.743,0.781,0.692,0.836 and 0.869,respectively.AUC value of combined detection was significantly greater than that of single index.Sensitivity and specificity of combined detection were the highest for diagnosis of AMI.Conclusion Levels of serum cTnI,hs-CRP,IL-17 and copeptin are significantly increased in AMI patients.Multiple indexes may cooperate and jointly participate in AMI process.The combined detection can improve the clinical diagnostic sensitivity and specificity of early AMI.It has a good application value for AMI diagnosis.
作者
张鹏
侯丽
林杰
张红
ZHANG Peng;HOU Li;LIN Jie;ZHANG Hong(Department of Internal Medicine,Longquanyi District Hospital of Traditional Chinese Medicine,Chengdu 610100,China;Department of Cardiology,Longquanyi District Hospital of Traditional Chinese Medicine,Chengdu 610100,China;Intensive Care Unit,Shuangliu District Hospital of Traditional Chinese Medicine,Chengdu 610000,China;Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《实用医院临床杂志》
2020年第5期200-203,共4页
Practical Journal of Clinical Medicine
