摘要
目的探讨缺血修饰清蛋白(ischemia modified albumin,IMA)、血清胱抑素C(cystatin C,CysC)与急性冠状动脉事件全球登记(Global Registry of Acute Coronary Events,GRACE)评分联合检测对急性冠状动脉综合征(acute coronary syndrome,ACS)患者的诊断及预后判断的影响。方法选择2016年6月至2017年12月在山东大学齐鲁医院(青岛)诊治的110例ACS患者(研究组)和同期接受体检的60名健康者(对照组)作为本次研究对象,对比分析2组IMA、CysC浓度与GRACE评分,观察ACS患者主要不良心血管事件(major adverse cardiovascular event,MACE)发生率,并分析IMA、CysC浓度与GRACE评分用于ACS早期鉴别诊断的价值。结果对照组IMA浓度明显高于研究组,对照组CysC浓度和GRACE评分均明显低于研究组,差异均具有统计学意义(P<0.05)。低浓度IMA、高浓度CysC和GRACE高分值的ACS患者,MACE发生率明显升高(P<0.05)。ST段抬高型心肌梗死和非ST段抬高型心肌梗死患者的CysC浓度和GRACE评分均明显高于不稳定型心绞痛患者,差异具有统计学意义(P<0.05)。IMA、CysC浓度与GRACE评分诊断ACS的灵敏度分别为76.36%、70.91%和56.36%,特异性分别为80.91%、78.18%和73.64%,IMA+CysC+GRACE评分联合预测ACS患者MACE发生的灵敏度和特异性分别为87.27%和92.73%,均显著高于单独预测,差异具有统计学意义(P<0.05)。结论IMA、CysC、GRACE评分3者联合预测对ACS患者预后判断有较高临床价值。
Objectives To observe the diagnostic and predictive value of concentrations of ischemia modified albumin (IMA),cystatin C(CysC)and Global Registry of Acute Coronary Events(GRACE)risk score for patients with acute coronary syndrome(ACS).Methods Totally 110 patients with ACS treated in Qilu Hospital of Shandong University (Qingdao)from June 2016 to December 2017 were selected as research group,and a total of 60 healthy subjects were selected as control group.Serum concentrations of IMA,CysC and GRACE risk score were compared between the two groups,and the incidence of major cardiovascular adverse events(MACE)in patients with ACS were observed.Diagnostic value of serum concentrations of IMA,CysC and GRACE risk score in early differential diagnosis of ACS were analyzed.Results Serum concentration of IMA in control group was higher than that in research group,and serum concentration of CysC and GRACE risk score in control group were lower than those in research group(P<0.05).Incidence of MACE in low serum concentration of IMA,high serum concentration of CysC and high scores of GRACE patients with ACS were significantly increased(P<0.05).Serum concentration of CysC and GRACE risk score in ST-segment elavation and non-ST-segment elevation myocardial infarction patients were significantly higher than those in unstable angina patients(P<0.05).Sensitivities of serum concentrations of IMA,CysC and GRACE risk score in diagnosing ACS were 76.36%,70.91% and 56.36%,specificities were 80.91%,78.18% and 73.64%.The sensitivity and specificity of IMA+CysC+GRACE risk score in predicting ACS was 87.27% and 92.73%,which were significantly higher than those of single detection(P<0.05).Conclusions Serum concentrations of IMA,CysC and GRACE have correlations, and they can improve the prognostic of cardiac events in patients with ACS.
作者
王革
鲁成龙
尹弘霁
张宁
李进
WANG Ge;LU Cheng-long;YIN Hong-ji;ZHANG Ning;LI Jin(Department of Emergency,Qilu Hospital of Shandong University(Qingdao),Qingdao,Shandong 266035, China;Department of Cardiology,Qilu Hospital of Shandong University(Qingdao),Qingdao,Shandong 266035,China)
出处
《岭南心血管病杂志》
2019年第5期499-504,共6页
South China Journal of Cardiovascular Diseases
