摘要
目的探讨血清肌酸激酶同工酶(CK-MB)、心肌钙蛋白(cTnT)及基质金属蛋白酶-9(MMP-9)对急性心肌梗死(AMI)诊断的应用价值。方法选取100例AMI患者(AMI组)、100例不稳定型心绞痛患者(UAP组)以及100例健康体检者(对照组)为研究对象。检测三组受试人员血清CK-MB、cTnT及MMP-9水平,采用受试者工作曲线(ROC)分析三项指标在AMI诊断中的价值,探讨AMI患者血清CK-MB、cTnT及MMP-9之间的相关性。结果 AMI组患者血清CK-MB、cTnT及MMP-9水平明显高于UAP组和对照组,而UAP组患者血清CK-MB、cTnT及MMP-9水平又明显高于对照组,差异均具有统计学意义(P<0.05)。AMI患者血清CK-MB、cTnT及MMP-9水平随着病变血管支数增加而明显提高,差异有统计学意义(P<0.05)。根据ROC曲线分析可得CK-MB、cTnT及MMP-9诊断AMI的最佳临界值为CK-MB>30.56U/L、cTnT>0.46μg/L、MMP-9>213.27ng/L,其ROC曲线下面积分别为0.873、0.890、0.877,诊断敏感性分别为64.0%、74.0%、85.0%,特异性分别为90.0%、88.5%、74.0%。三项指标联合检测敏感性明显高于单独检测,差异具有统计学意义(P<0.05)。AMI组患者血清CK-MB、cTnT及MMP-9之间呈正相关性(P<0.05)。结论AMI患者血清CK-MB、cTnT及MMP-9呈高表达,其水平与患者病情密切相关,联合检测血清CK-MB、cTnT及MMP-9水平有助于AMI的早期诊断和治疗。
Objective To investigate the application value of serum creatine kinase isoenzyme-MB （CK-MB）,myocardial troponin T （cTnT） and matrix metalloproteinase-9 （MMP-9） in diagnostic of acute myocardial infarction （AMI）. Methods 100 patients with AMI （AMI group）,100 patients with unstable angina pectoris （UAP group） and 100 healthy persons （control group） were enrolled in this study.The levels of serum CK-MB,cTnT and MMP-9 in three groups were detected.The values of CK-MB,cTnT and MMP-9 in diagnostic of AMI were analyzed by ROC curve.The correlation of CK-MB,cTnT and MMP-9 level in serum of patients with AMI were discussed. Results The serum CK-MB,cTnT and MMP-9 level in AMI group were significantly higher than those in UAP group and control group;while those indexes in UAP group were significantly higher than control group （ P 〈0.05）.The levels of serum CK-MB,cTnT and MMP-9 in AMI group were significantly increased with the severity of coronary artery lesions （ P 〈0.05）.According to ROC curve,the best critical value of CK-MB,cTnT and MMP-9 were CK-MB〉30.56 U/L,cTnT〉0.46μg/L and MMP-9〉 213.27 ng/L.The areas under the ROC curves were 0.873,0.890 and 0.877,with the sensitivity were 64.0 %,74.0%,85.0% and specificity were 90.0%,88.5%,74.0%.The sensitivity of combined detection was significantly higher than detection of three indexes separately （ P 〈0.05）.The level of serum CK-MB,cTnT and MMP-9 showed significant positive correlation in patients with AMI （ P 〈0.05）. Conclusion Expression of serum CK-MB,cTnT and MMP-9 are higher in patients with AMI and the level is closely related with the severity of coronary artery lesions.Combined detection of serum CK-MB,cTnT and MMP-9 is contributed to early diagnosis and treatment of AMI.
作者
黄剑
姜玉章
李冬
张迎梅
HUANG Jian;JIANG Yuzhang;LI Dong;ZHANG Yingmei(Department of Clinical Laboratory,Huai′an No.1 People′s Hospital Affiliated to Nanjing Medical University,Huai′an,Jiangsu 223300,China;Department of Clinical Laboratory,Tongji Hospital Affiliated to Tongji University of Shanghai,Shanghai 200065,China)
出处
《国际检验医学杂志》
CAS
2018年第17期2098-2101,共4页
International Journal of Laboratory Medicine
基金
国家自然科学基金资助项目(81472179)
关键词
急性心肌梗死
肌酸激酶同工酶
心肌钙蛋白
基质金属蛋白酶-9
诊断
acute myocardial infarction
creatine kinase isoenzyme-MB
myocardial troponin T
matrix metalloproteinase-9
diagnostic
