IMA、hs-CRP、MYO、CK-MB、hs-cTnT 联合检测在急性冠脉综合症诊断中的价值比较

摘要

目的：探讨血清中缺血个儿蛋白（IMA）、超敏 C 反应蛋白（hs-CRP）、肌红蛋白（MYO）、肌酸激酶同工酶（CK-MB）、超敏肌钙蛋白（hs-cTnT）在急性冠状动脉综合征（ACS）患者早期诊断的价值。方法测定99例健康对照组和94例 ACS 患者（其中不稳定性心绞痛40例，非 ST 段抬高的心肌梗死即非 Q 波心肌梗死20例，ST 段抬高的心肌梗死即 Q 波心肌梗死34例）中IMA、hs-CRP、MYO、CK-MB、hs-TNT 的含量。通过 ROC 曲线比较5种标志物在 ACS 早期诊断中的诊断效率、灵敏度、特异性、阴阳性预测值。结果血清中 IAM、hs-CRP、MYO、CK-MB、hs-cTnT 检测结果在病例组 UAP，NSTEMI，STEMI 3组和正常对照组间比较，差异均有统计学意义（P ＜0．05）。其中 IMA、hs-CRP、MYO、CK-MB、hs-cTnT 在 UAP 与 NSTEMI 组，UAP 与NSTEMI 组间比较，差异均有统计学意义（P ＜0．05），NSTEMI 与 STEMI 组间比较，差异均无统计学意义（P ＞0．05）。结论在ACS 中，多个指标的联合检测能取得早期诊断的价值。%Objective To investigate the value of serum ischemia-modified protein (IMA),hypersensitivity C reaction protein (hs-CRP),myoglobin (MYO)creatine kinase MB (CK-MB)and ultra-sensitivity troponin T (hs-cTnT)in the early diagnosis of patients with acute coronary syndrome(ACS).Methods Serum levels of IMA,hs-CRP,MYO,CK-MB and hs-cTnT were meaused in 94 patients with ACS[including 40 cases of unstable angina pectoris(UAP),20 cases of non-ST segment elevation myocardial in-farction(NSTEMI),non-Q wave myocardial infarction and 34 cases of ST segment elevation myocardial infarction(STEMI),Q wave myocardial infarction]and 99 cases of controls.The efficiency,sensitivity,specificity,negative and positive predictive values in the early diagnosis of ACS were compared among 5 kinds markers by the ROC curve.Results The detection results of serum IMA,hs-CRP,MYO,CK-MB and hs-cTnT had statistically significant differences between the UAP,NSTEMI and STEMI groups with the normal control group (P <0.05),serum IMA,hs-CRP,MYO,CK-MB and hs-cTnT had statistically significant differences between the UAP group with the NSTEMI group and between the UAP group with STEMI group (P <0.05),but the difference between NSTEMI and STEMI group group was not statistically significant (P >0.05).Conclusion In the patients with ACS,the multiple indicators combined detection can achieve the early diagnostic value.