摘要
目的初步探讨多种心脏生物标志物联合检测在非ST段抬高急性冠脉综合征(NSTEACS)预后评价中的意义。方法纳入NSTEACS患者262例,按照是否发生心脏事件分为两组。检测所有研究对象的血清末端B型利钠钛原(NT-proBNP)、超敏C反应蛋白(hs-CRP)、肌酸肌酶同工酶(CK-MB)、肌钙蛋白(IcTnI)、过氧化物酶体增殖因子活化受体A(PPAR-A)、胎盘生长因子(PLGF)及人可溶性P-选择素(sP-selectin)及糖化血红蛋白水平。选择出其中对预后评价有影响的生物标志物,进一步建立能够对NSTEACS患者进行预后评价的数学模型。结果通过对心脏事件组和非心脏事件组的临床基线特征和生化标志物比较发现,两组间左室后壁(LVD)、左室射血分数(LVEF)、NT-proBNP、hs-CRP、cTnI、CK-MB、PPAR-A、PLGF及sP-selectin差异具有统计学意义(P<0.05),而糖化血红蛋白(HbA1c)则差异无统计学意义(P>0.05);利用Logistic逐步回归方法分析发现其特异度和灵敏度分别为95.0%和78.4%,绘制ROC曲线,ROC曲线下面积为97.8。结论上述生化标志物的联合检测结果对心脏预后的评估具有高度的特异性和准确性。
Objective To discuss the significance of the combined detection of multi-biochemical makers for evaluating the prognosis of non-ST-segment elevation acute coronary syndromes （NSTEACS）. Methods Two hundred and sixty-two patients with NSTEACS were divided into two groups according to the occurrence of cardiac events. The serum levels of NT-proBNP, hs-CRP, CK-MB, cTnI, PPAR-A, PLGF, sP-selectin and HbA1 c were mea-sured. The biochemical markers of significance to the evaluation of prognosis were selected to create a mathematical model for further predicting the prognosis of patients with NSTEACS. Results Comparison of the clinical baseline characteristics and biochemical markers between the cardiac events group and the non-cardiac events group showed a statistically significant difference in LVD, LVEF, NT-proBNP, hs-CRP, cTnI, CK-MB, PPAR-A, PLGF and sP-selectin （P〈0.05）. HbA1c showed no statistically significant difference between the two groups. The specificity and sensitivity was 95.0% and 78.4%, respectively. The area under the ROC curve was 97.8. Conclusion Combined detection of NT-proBNP, hs-CRP, PPAR-A, PLGF and cTnI has high specificity and accuracy in the evaluation of cardiac prognosis.
出处
《海南医学》
CAS
2013年第3期323-326,共4页
Hainan Medical Journal
关键词
生化标志物
数学模型
非ST段抬高急性冠脉综合征
预后
Biochemical makers
Mathematical model
Non-ST-segment elevation acute coronary syn-dromes
Prognosis
作者简介
通讯作者：王晓红。E-mail：wxhl9740328@163．com
