摘要
目的检测冠心病患者的神经细胞黏附分子-1 (NCAM-1)、氨基末端B型钠尿肽原(NT-proBNP)和肌钙蛋白I (cTnI)浓度,并探讨其临床诊断价值。方法将惠州市第六人民医院2019年1~6月诊治的67例冠心病患者纳入冠心病组,同期年龄和性别匹配的健康志愿者70例作为对照组。冠心病组又分为急性心肌梗死(AMI)组、不稳定型心绞痛(UAP)组和稳定型心绞痛(SAP)组。所有受检者采用ELISA法检测血清NCAM-1浓度,免疫荧光法检测NT-proBNP和cTnI浓度。采用受试者工作曲线(ROC)分析NCAM-1、NT-proBNP和cTnI对冠心病的诊断价值。结果冠心病组患者的血清NCAM-1浓度明显低于对照组,而血清NT-pro BNP和c TnI浓度明显高于对照组,差异均有统计学意义(P<0.05);AMI组、UAP组和SAP组患者的血清NCAM-1浓度依次升高,而NT-proBNP和cTnI浓度依次降低,差异均有统计学意义(P<0.05)。患者的血清NCAM-1浓度随心功能分级增高而降低,而血清NT-proBNP和cTnI浓度随心功能分级增高而增高,差异均有统计学意义(P<0.05),当截断值为133.43 ng/mL时,血清NCAM-1浓度诊断冠心病的ROC曲线下面积(AUC)为0.953 (95%CI 0.919~0.977,P=0.000 8),敏感性和特异性分别为89.9%和97.5%;当截断值为321.00 ng/L时,血清NT-proBNP诊断冠心病的AUC为0.941 (95%CI 0.932~0.960,P=0.001 7),敏感性和特异性分别为85.1%和97.0%;当截断值为0.205μg/L时,血清cTnI诊断冠心病的AUC为0.855 (95%CI 0.792~0.919,P=0.001 3),敏感性和特异性分别为65.5%和97.5%。结论血清NCAM-1、NT-proBNP和cTnI均可作为冠心病的诊断指标,NCAM-1对冠心病诊断价值高,其可能为冠心病潜在血清标志物。
Objective To investigate the concentration of neural cell adhesion molecule-1(NCAM-1),amino terminal B-type natriuretic peptide(NT-proBNP),and cardiac troponin I(cTnI)in patients with coronary heart disease and analyze their clinical diagnostic value.Methods Sixty-seven coronary heart disease patients,who admitted to the Sixth People's Hospital of Huizhou from Jan.to June 2019,were enrolled as coronary heart disease group.Seventy healthy subjects who had matched age and gender were recruited in the healthy control group.Coronary heart disease group included acute myocardial infarction(AMI)group,unstable angina pectoris(UAP)group,and stable angina pectoris(SAP)group.Serum NCAM-1 concentration were measured by ELISA.Serum NT-proBNP and cTnI concentrations were detected by time-resolved fluorescence immunoassay(TRFIA).The receiver operating characteristic(ROC)curve was used to analyze the diagnosis values of NCAM-1,NT-proBNP,and cTnI for coronary heart disease patients.Results Serum NCAM-1 concentrations were significantly lower in coronary heart disease group than in healthy control group,while the concentration of NT-proBNP and cTnI in coronary heart disease group was significantly higher than that in healthy control group(P<0.05).The serum NCAM-1 concentrations in AMI group,UAP group and SAP group were increased in turn,the concentration of NT-proBNP and cTnI in AMI subgroup,UAP subgroup and SAP subgroup decreased in turn,with statistically significant differences(all P<0.05).The serum concentration of NCAM-1 decreased with the increase of functional grade,while the concentration of NT-proBNP and cTnI increased with the increase of functional grade(P<0.05).When the cut-off value was 133.43 ng/mL,the area under the ROC curve(AUC)of serum NACM-1 was 0.953(95%CI 0.919-0.977,P=0.0008),and the sensitivity and specificity were 89.9%and 97.5%respectively.When the cut-off value was 321.00 ng/L,the area under the ROC curve(AUC)of serum NT-proBNP was 0.941(95%CI 0.932-0.960,P=0.0017),and the sensitivity and specificity wer
作者
曾伟雄
曾金财
方快发
ZENG Wei-xiong;ZENG Jin-cai;FANG Kuai-fa(Department of Cardiology,the Sixth People's Hospital of Huizhou,Huizhou 516200,Guangdong,CHINA)
出处
《海南医学》
CAS
2020年第23期3013-3016,共4页
Hainan Medical Journal
基金
广东省惠州市科技计划项目(编号:190412094572760)。
关键词
冠心病
神经细胞黏附分子-1
氨基末端B型钠尿肽原
肌钙蛋白I
受试者工作曲线
诊断价值
Coronary heart disease
Neural cell adhesion molecule-1(NCAM-1)
Amino terminal B-type natriuretic peptide(NT-proBNP)
Cardiac troponin I(cTnI)
Receiver operating characteristic curve(ROC)
Diagnosis value
