| 血清Copeptin、BNP及cTnI在老年急性ST段抬高型心肌梗死诊断中的价值 |
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| 引用本文： | 吴忠璟,夏可辉,钟书刚.血清Copeptin、BNP及cTnI在老年急性ST段抬高型心肌梗死诊断中的价值[J].中华全科医学,2019,17(8):1368-1371. |
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| 作者姓名： | 吴忠璟 夏可辉 钟书刚 |
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| 作者单位： | 1. 海口市妇幼保健院检验科, 海南 海口 570102; |
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| 基金项目： | 海南省医药卫生科研基金项目(16A50275) |
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| 摘 要： | 目的探讨血清和肽素(Copeptin)、脑钠肽(BNP)及心肌肌钙蛋白I(cTnI)在老年急性ST段抬高型心肌梗死(STEMI)诊断中的价值。方法选取2016年1月-2018年3月海口市妇幼保健院收治的120例STEMI患者,采集胸痛发生4 h内(4 h)、12 h、24 h、48 h、5 d和健康对照组的静脉血,检测Copeptin、BNP及cTnI水平变化。应用受试工作特征曲线(ROC)评价Copeptin、BNP及cTnI在AMI诊断中的价值。采用Pearson相关分析分析STEMI患者血清Copeptin水平与BNP、cTnI水平的相关性。结果 STEMI组4 h、12 h、24 h、48 h、5 d血清Copeptin、BNP及cTnI水平均明显高于对照组(均P<0.05),STEMI组4 h、12 h、24 h、48 h血清Copeptin、BNP及cTnI水平均明显高于5 d(均P<0.05),STEMI组12 h、24 h血清cTnI水平均明显高于4 h和48 h(均P<0.05)。ROC曲线分析显示,血清Copeptin、BNP及cTnI诊断老年STEMI的最佳截值分别为19.38 pmol/L,1560.74 ng/L,6.75 ng/mL,3项联合诊断老年STEMI的敏感度和特异度最高,为96.5%和93.6%。相关分析显示,STEMI患者血清Copeptin水平与BNP及cTnI水平均具有明显正相关性(r=0.792,P<0.01;r=0.857,P<0.01)。结论血清Copeptin、BNP及cTnI水平在老年STEMI患者中明显升高,3项联合检测对老年STEMI诊断具有较高的价值。
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| 关 键 词： | 急性ST段抬高型心肌梗死 老年人 和肽素 脑钠肽 心肌肌钙蛋白I |
| 收稿时间： | 2018-11-22 |
Diagnostic value of serum Copeptin,BNP and cTnI in elderly patients with acute ST segment elevation myocardial infarction |
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| Authors: | WU Zhong-jing XIA Ke-hui ZHONG Shu-gang |
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| Affiliation: | Department of Clinical Laboratory, Haikou Maternal and Child Health Care Hospital, Haikou, Hainan 570102, China |
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| Abstract: | Objective To investigate the value of serum peptide (Copeptin), brain natriuretic peptide (BNP) and cardiac troponin I (cTnI) in the diagnosis of acute ST segment elevation myocardial infarction (STEMI) in the elderly. Methods The changes in the levels of Copeptin, BNP and cTnI were detected in 120 cases of STEMI patients with chest pain within 4 hours (4 h), 12 hours, 24 hours, 48 hours, 5 days and healthy controls. The value of Copeptin, BNP and cTnI in the diagnosis of AMI was evaluated by ROC. Pearson correlation was used to analyze the correlation between serum Copeptin level and BNP, cTnI levels in STEMI patients. Results Serum Copeptin, BNP and cTnI levels in STEMI group at 4 hours, 12 hours, 24 hours, 48 hours and 5 days were significantly higher than those in control group (all P<0.05). In STEMI group, serum Copeptin, BNP and cTnI levels in 4 hours, 12 hours, 24 hours and 48 hours were significantly higher than 5 days (all P<0.05). In STEMI group, serum cTnI levels in 12 hours, 24 hours were significantly higher than 4 hours and 48 hours (all P<0.05). The ROC curve analysis showed that the best cut-off values of serum Copeptin, BNP and cTnI for diagnosis of elderly STEMI were 19.38 pmol/L, 1 560.74 ng/L, 6.75 ng/mL, and three combined diagnosis of senile STEMI were the highest sensitivity and specificity, 96.5% and 93.6%. Correlation analysis showed that serum Copeptin level in STEMI patients were positively correlated with BNP and cTnI levels (r=0.792, P<0.01; r=0.857, P<0.01). Conclusion Serum Copeptin, BNP and cTnI levels in elderly patients with STEMI increase significantly, the three joint detection of elderly STEMI diagnosis has high value. |
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| Keywords: | Acute ST segment elevation myocardial infarction Elderly Copeptin Brain natriuretic peptide Cardiac troponin I |
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