摘要
目的探讨可溶性生长刺激表达基因2蛋白(sST2)、氨基末端脑钠肽前体(NT-proBNP)及同型半胱氨酸(Hcy)水平在急性冠脉综合征(ACS)中的表达及临床意义。方法选取2017年1月~2018年6月我院收治的87例ACS患者作为研究对象,根据临床表现、心电图、心肌损伤标志物的不同分为ST段抬高型心肌梗死(STEMI)组(31例)、非ST段抬高型心肌梗死(NSTEMI)组(30例)、不稳定型心绞痛(UA)组(26例);选取同期住院的非ACS患者100例作为对照组。检测并比较四组的sST2、NT-proBNP及Hcy水平,通过受试者工作特征(ROC)曲线评估sST2、Hcy及NT-proBNP诊断ACS的价值。结果STEMI组和NSTEMI组的sST2水平高于对照组和UA组,差异均有统计学意义(P<0.05),病情越严重,sST2水平越高;STEMI组、NSTEMI组和UA组的NT-proBNP水平高于对照组,差异均有统计学意义(P<0.05);STEMI组和NSTEMI组的Hcy水平高于对照组,差异均有统计学意义(P<0.05)。sST2的ROC曲线下面积(AUC)为0.755(95%CI:0.685~0.824,P<0.001),最佳临界点为36.250,灵敏度为65.5%,特异度为73.0%;NT-proBNP的AUC为0.725(95%CI:0.653~0.797,P<0.001),最佳临界点为601.865,灵敏度为81.6%,特异度为57.0%;Hcy的AUC为0.652(95%CI:0.574~0.730,P<0.001),最佳临界点为10.250,灵敏度为66.7%,特异度为58.0%。三者联合检测的AUC为0.789,灵敏度为58.6%,特异度为89.0%。结论血清sST2、NT-proBNP、Hcy及联合检测可作为诊断ACS的辅助指标,且sST2与疾病严重程度相关。
Objective To investigate the expression and clinical significance of soluble growth stimulating gene 2 protein(sST2),amino terminal pro-brain natriuretic peptide(NT pro-BNP)and homocysteine(Hcy)in acute coronary syndrome(ACS).Methods A total of 87 patients with ACS admitted to our hospital from January 2017 to June 2018 were selected as the research objects,they were divided into three groups:ST segment elevation myocardial infarction(STEMI)group(31 cases),non ST segment elevation myocardial infarction(NSTEMI)group(30 cases)and unstable angina(UA)group(26 cases),according to the different clinical manifestations,ECG and myocardial injury markers.100 cases of non ACS patients at the same period were taken as the control group.The levels of sST2,NT proBNP and Hcy were measured and compared among the four groups.The diagnostic value of sST2,Hcy and NT pro-BNP in ACS was evaluated by ROC curve.Results The levels of sST2 in STEMI group and NSTEMI group were higher than those in control group and UA group,the differences were statistically significant(P<0.05),the more serious the disease,the higher the level of sST2.The level of NT pro-BNP in STEMI group,NSTEMI group and UA group were higher than those in the control group,the differences were statistically significant(P<0.05).The Hcy level of STEMI group and NSTEMI group were higher than those of the control group,the differences were statistically significant(P<0.05).The area under ROC curve(AUC)of sST2 was 0.755(95%CI was 0.685-0.824,P<0.001),the best critical point was 36.250,the sensitivity was 65.5%,and the specificity was 73.0%.The area under ROC curve(AUC)of NT-proBNP was 0.725(95%CI was 0.653-0.797,P<0.001),the best critical point was 601.865,the sensitivity was 81.6%,the specificity was 57.0%.The AUC of Hcy was 0.652(95%CI was 0.574-0.730,P<0.001),the best critical point was 10.250,the sensitivity was 66.7%,and the specificity was 58.0%.Combined detection of the three,the AUC was 0.789,the sensitivity was 58.6%,and the specificity was 89.0%.Conclusion Serum s
作者
张巧玲
邹文毕
刘家超
ZHANG Qiao-ling;ZOU Wen-bi;LIU Jia-chao(Department of Clinical Laboratory,Sanshui District People′s Hospital of Foshan City,Guangdong Province,Foshan 528100,China;Department of Internal Medicine-Cardiovascular,Sanshui District People′s Hospital of Foshan City,Guangdong Province,Foshan 528100,China)
出处
《中国当代医药》
2019年第33期4-7,共4页
China Modern Medicine
基金
广东省佛山市自筹经费类科技计划项目(2016AB001415)
