摘要
目的探讨急性冠脉综合征(acute coronary syndromes,ACS)患者不同心肌标志物水平变化以及联合多种心肌志记物对ACS的预测作用。方法选取ACS患者100例,对照组89例,分别检测血清中血脂常规生化指标;心肌损伤标志物包括肌酸激酶同工酶(Creatine kinase isoenzyme,CK-MB)、肌钙蛋白T(troponin T,TnT)、肌红蛋白(myoglobin,Myo)、超敏肌钙蛋白T(hypersensitive troponin,hs-TnT)、脑钠肽(brain natriuretic peptide,BNP);炎症因子包括高迁移率族蛋白1(high mobility group box-1 protein,HMGB1)、超敏C-反应蛋白(high sensitive C-reactive protein,hs-CRP);白细胞(white blood cell,WBC);中性粒细胞百分比以及空腹血糖水平,并比较两组之间的差异。结果 ACS组患者血清中BNP、CK-MB、TnT、Myo、hs-CRP、hs-TnT、以及HMGB1水平均高于对照组(P<0. 05); hsCRP、HMGB1联合Myo构建模型对ACS测试集数据进行诊断预测,阴性预测率为81. 82%,阳性预测率为95. 24%,AUC为0. 906 3; hs-CRP、HMGB1与CK-MB为ACS发生的危险因素,OR分别为1. 95(95%CI:1. 32～2. 55)、7. 44(95%CI:6. 51～8. 14)与3. 51(95%CI:2. 33～4. 59); Myo为ACS发生的保护因素,OR为0. 17(95%CI:0. 10～0. 35)。结论血清hs-CRP、HMGB1与Myo构建预测模型有助于对ACS患者的早期诊断。
Objective To establish a predictive model for acute coronary syndrome(ACS)based on Hs-CRP,HMGB1and Myo.Methods One hundred ACS patients(ACS group)and89healthy subjects(control group)were enrolled in the study.Blood lipids(TC,TG,HDL and LDL),myocardial injury markers(CK-MB,TnT,Myo,hs-TnT and BNP),inflammatory factors(HMGB1and hs-CRP),polymorphic particles and fasting blood glucose levels were measured and compared between two groups.Logistic regression was used to establish a predictive model for ACS.Results The CK-MB,TnT,Myo,hs-TnT,HMGB1,BNP and hs-CRP levels in ACS group were significantly higher than those in control group(P<0.05).Logistic regression analysis showed that hs-CRP,HMGB1and CK-MB were the risk factors for ACS(OR=1.95,95%CI:1.322.55;OR=7.44,95%CI:6.518.14;OR=3.51,95%CI:2.334.59),and Myo was the protective factor of ACS(OR=0.17,95%CI:0.100.35).A predictive model was established based on hs-CRP,HMGB1and Myo.The area under curve(AUC)of the model was0.9063,and the positive predictive value and the negative predictive value were95.24%and81.82%,respectively.Conclusion Serum hs-CRP,HMGB1and Myo are of value in early diagnosis of patients with acute coronary syndrome.
作者
崔丽
刘颖
丛新鹏
方明
宁忠平
李新明
CUI Li;LIU Ying;Cong Xin-peng;Fang Ming;Ning Zhong-ping;Li Xin-ming(Dept. Cardiology, Zhoupu Hospital, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China)
出处
《同济大学学报（医学版）》
CAS
2018年第6期97-101,共5页
Journal of Tongji University(Medical Science)
基金
上海市自然科学基金项目(15ZR1437300)
上海市卫生和计划生育委员会科研课题(201540116)
上海市浦东新区科委创新基金项目(PKJ2014-Y31)
上海市浦东新区卫计委优青人才(PWRq2014-34)
