天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (11): 1319-1322.doi: 10.11958/j.issn.0253-9896.2015.11.026

• 应用研究 • 上一篇    下一篇

和肽素与肌钙蛋白联合检测在急性心肌梗死期诊断中的应用价值

李伟宁， 魏殿军， 宁莉#br#   

  1. 天津医科大学第二医院检验科 （邮编 300211）
  • 收稿日期:2014-12-23 修回日期:2015-06-16 出版日期:2015-11-15 发布日期:2015-11-15
  • 通讯作者: 李伟宁 E-mail:liweining14@163.com
  • 作者简介:李伟宁 （1983）， 女， 初级检验技师， 主要从事临床生物化学检验工作

The diagnostic value of copeptin combined with cardiac troponin in the early diagnosis of acute myocardial infarction#br#

LI Weining, WEI Dianjun, NING Li#br#   

  1. Department of Laboratory, The Second Affiliated Hospital of Tianjin Medical University, Tianjin 300211, China
  • Received:2014-12-23 Revised:2015-06-16 Published:2015-11-15 Online:2015-11-15

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摘要： 目的 探讨和肽素（copeptin）和心肌肌钙蛋白 I（cTnI）、 高敏心肌肌钙蛋白 T（hs-TnT）联合检测时对急性心肌梗死（AMI）的诊断价值。方法 AMI 患者 152 例（AMI 组）， 同期健康体检者 143 例（对照组）。（1）考察 2 组 0、4、 6 及 12 h copeptin、 cTnI 及 hs-TnT 水平差异。（2）对 2 组行 copeptin 与 cTnI 合检测（cop/cTnI）、 copeptin 与 hsTnT 联合检测 （cop/hs-TnT）。考察 AMI 组发病后不同时间点上述不同检测指标阳性检出率情况。（3） 判断发病即刻各种心肌标志物对 AMI 诊断的敏感度、 特异度及准确度。 结果 （1） 2 组 copeptin 在发病 0、 4 、 6 和 12 h 时差异有统计学意义（P < 0.05）。2 组 cTnI 与 hs-TnT 在 0 h 时差异无统计学意义。（2） cop/cTnI 和 cop/hs-TnT 联合检测组在不同发病时刻较各自单独检测均具有更高的阳性检出率。（3） cop/cTnI 和 op/hs-TnT 联合检测的敏感度、 特异度以及准确度均高于其单独检测。cop/hs-TnT 联合检测最佳。结论 cop/cTnI 和 cop/hs-TnT 联合检测在 AMI 发病早期即具有较高的敏感度、 特异度和准确度， 在临床疾病诊断中具有很好的应用价值。

关键词: 心肌梗死, 急性病, 早期诊断, 敏感性与特异性, 和肽素, 心肌肌钙蛋白 I, 高敏肌钙蛋白 T

Abstract: Objective To investigate the diagnostic value of combined copeptin, cardiac troponin I (cTnI) and high sensitive cardiac troponin T (hs-TnT) in determination of acute myocardial infarction (AMI). Methods A total of 152 patients with AMI were selected as AMI group and 143 healthy examinees during the same period were selected as control group. (1)The levels of copeptin, cTnI and hs-TnT were detected at 0, 4, 6 and 12 h in two groups. (2) The combined detection of cop/cTnI and cop/hs-TnT were studied. The positive rates of these items were evaluated at different time points of AMI. (3) The diagnostic sensitivity, specificity and accuracy of different cardiac biomarkers for AMI were compared. Results (1) There were significant differences in copeptin at 0, 4, 6 and 12 h between two groups (P < 0.05). There were no significant differences in cTnI and hs- TnT between two groups. (2) cop/cTnI and cop/hs- TnT combined detection showed better positive rates than those of copeptin, cTnI or hs-TnT detection alone. (3) In addition, the combined detection of cop/cTnI and cop/cTnI improved significantly the diagnostic sensitivity of AMI. Compared to cop/cTnI combination, cop/hs-TnT combination detection showed better diagnostic sensitivity, specificity and accuracy for AMI. Conclusion The combined detection of cop/cTnI and cop/hs-TnT are very helpful for early diagnosis of AMI, which shows a very good diagnostic value in clinical application.

Key words: myocardial infarction, acute disease, early diagnosis, sensitivity and specificity, copeptin, cardiac troponin I, high sensitive cardiac troponin T