摘要
目的:探讨高敏C反应蛋白(hsCRP)、D-二聚体(D-D)、脑钠肽(BNP)、同型半胱氨酸(Hcy)水平对急性非ST段抬高型心梗(NSTEMI)患者发生心衰的诊断价值。方法:选择在本院心血管内科诊疗的NSTEMI患者148例作为研究对象,根据是否发生心衰分为心衰组(54例)和无心衰组(94例)。检测患者血清Hcy、hsCRP、D-D、BNP水平;采用多因素Logistic回归分析法分析心衰发生的影响因素;采用受试者工作特征曲线(ROC)评价血清BNP、Hcy、hsCRP、D-D水平对NSTEMI患者发生心衰的诊断价值。结果:心衰组患者hsCRP、D-D、BNP、Hcy水平均显著高于无心衰组(P均=0.001);多因素Logistic回归分析显示D-D、BNP、Hcy、hsCRP水平升高均是NSTEMI患者发生心衰的独立危险因素(OR=1.025~2.586,P均=0.001)。ROC结果显示,血清hsCRP、D-D、BNP、Hcy水平诊断心衰患者的曲线下面积(AUC)分别为0.734、0.956、0.908、0.815,对应的敏感度分别为75.93%、88.89%、94.44%、62.96%,特异度分别为63.83%、96.81%、74.47%、88.30%;四者联合预测心衰患者的AUC为0.990,敏感度为92.59%,特异度为97.87%,联合检测的诊断价值优于各项单独检测。结论:NSTEMI并发心衰患者血清hsCRP、BNP、Hcy、D-D水平显著升高,是心衰发生的独立危险因素,且联合检测有助于诊断心衰。
Objective:To explore diagnostic value of serum levels of high sensitive C-reactive protein(hsCRP),D-dimer(D-D),brain natriuretic peptide(BNP)and homocysteine(Hcy)for heart failure(HF)in patients with acute non-ST-segment elevation myocardial infarction(NSTEMI).Methods:According to HF or not,a total of 148 NSTEMI patients treated in our department were divided into HF group(n=54)and no HF group(n=94).Serum levels of Hcy,hsCRP,D-D and BNP were measured in these patients;multivariate Logistic regression was used to analyze influencing factors for HF;ROC was used to assess diagnostic value of above index levels for HF in NSTEMI patients.Results:Compared with no HF group,there were significant rise in serum levels of hsCRP,D-D,BNP and Hcy in HF group,P=0.001 all;multivariate Logistic regression analysis indicated that elevated D-D,BNP,Hcy and hsCRP were independent risk factors for HF in NSTEMI patients(OR=1.025~2.586,P=0.001 all).ROC curve indicated that,area under the curve(AUC)of serum levels of hsCRP,D-D,BNP and Hcy in diagnosing HF was 0.734,0.956,0.908 and 0.815 respectively,sensitivity was 75.93%,88.89%,94.44%and 62.96%respectively,specificity was 63.83%,96.81%,74.47%and 88.30%respectively;AUC of combined detection of above four indexes in predicting HF was 0.990,sensitivity was 92.59%and specificity was 97.87%,diagnostic value of combined detection was better than each single detection.Conclusion:Serum levels of hsCRP,BNP,Hcy and D-dimer significantly rise in NSTEMI+HF patients.They are independent risk factors for HF,and combined detection is helpful for diagnosis of HF.
作者
陈泽江
李召祺
萧少武
吴娟
符雄
张腊喜
CHEN Ze-jiang;LI Zhao-qi;XIAO Shao-wu;WU Juan;FU Xiong;ZHANG La-xi(Department of Cardiology,People's Hospital of Wenchang City,Wenchang,Hainan,571300,China)
出处
《心血管康复医学杂志》
CAS
2022年第6期675-679,共5页
Chinese Journal of Cardiovascular Rehabilitation Medicine
基金
海南省卫生健康行业科研项目(20A200023)。
关键词
心肌梗死
C反应蛋白质
高半胱氨酸
Myocardial infarction
C-reactive protein
Homocysteine
