摘要
目的分析床边即时检测技术(POCT)检测肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌红蛋白(Mb)对急性心肌梗死(AMI)的早期诊断效能。方法回顾性分析2019年4月—2020年12月亳州市人民医院收治的137例拟诊为AMI患者的临床资料,根据心电图、心肌酶谱检测和冠状动脉造影检查结果分为AMI组和非AMI组。使用POCT技术检测并对比两组患者入院时的cTnI、CK-MB和Mb水平,使用受试者工作特征(ROC)曲线分析cTnI、CK-MB、Mb对AMI的早期诊断效能。结果137例患者中有88例AMI患者;POCT测定的AMI组cTnI、CK-MB和Mb水平明显高于非AMI组(P<0.05);POCT测定cTnI、CK-MB、Mb诊断AMI的最佳截断点(cut-off)分别为0.14 ng/mL、3.70 ng/mL、58.02 ng/mL,且各指标联合诊断AMI的灵敏度为100.00%,特异度与各指标对比差异无统计学意义(P>0.05),曲线下面积(AUC)均高于单独评估(P<0.05)。结论POCT技术能够快速、准确地检测心肌标志物,cTnI、CK-MB和Mb可作为AMI的早期诊断指标,对AMI的发生均有诊断价值,且联合诊断价值更高。
Objective To analyze the early diagnostic efficacy of troponin I(cTnI),creatine kinase isoenzyme(CK-MB)and myoglobin(Mb)detected by point-of-care testing(POCT)in patients with acute myocardial infarction(AMI).Methods A retrospective analysis of the clinical data of 137 patients with suspected AMI admitted to Bozhou People′s Hospital from April 2019 to December 2020 were divided into AMI group and non-AMI group according to routine electrocardiogram,detection of myocardial enzyme spectrum and coronary angiography.The cTnI,CK-MB and Mb levels on admission of the two groups of patients were detected by POCT and compared.Receiver operating characteristic(ROC)curve was used to analyze the early diagnosis efficacy of cTnI,CK-MB and Mb for acute myocardial infarction.Results Among 137 patients,88 patients were AMI.The levels of cTnI,CK-MB and Mb detected by POCT in the AMI group were substantially higher than those in the non-AMI group(P<0.05).The best cutoff point values of cTnI,CK-MB and Mb in the diagnosis of AMI were 0.14 ng/mL,3.70 ng/mL and 58.02 ng/mL,respectively.The sensitivity of the combined diagnosis of AMI was 100.00%,the specificity was not statistically different from each index(P>0.05),and the area under curve(AUC)was higher than the individual evaluation(P<0.05).Conclusion POCT can quickly and accurately detect myocardial markers.cTnI,CK-MB and Mb can be used as early diagnostic indicators of AMI,and they have diagnostic value for the occurrence of AMI.The combined diagnostic value of indicators is better.
作者
杜宣莉
牛帅
吴广福
朱德才
DU Xuanli;NIU Shuai;WU Guangfu;ZHU Decai(Department of Emergency Medicine,Bozhou People's Hospital,Bozhou Anhui 236800,China)
出处
《中国急救复苏与灾害医学杂志》
2022年第7期853-855,868,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
安徽省重点研究与开发计划(第一批)项目(编号:皖科资秘[2021]230号)
亳州市科研计划项目(编号:bzzc2020005)。
关键词
床边即时检测技术
肌钙蛋白Ⅰ
肌酸激酶同工酶
肌红蛋白
急性心肌梗死
诊断效能
Point-of-care testing
Cardiac troponinⅠ
Creatine kinase MB isoenzyme
Myoglobin
Acute myocardial infarction
Diagnostic efficacy
