肝素结合蛋白在ST段抬高性急性心肌梗死中的临床意义
投稿时间:2014-06-04  修订日期:2014-06-06  点此下载全文
引用本文:朱杰,孙红,蒋中英,张高峰,马雅英.肝素结合蛋白在ST段抬高性急性心肌梗死中的临床意义[J].医学研究杂志,2015,44(1):122-125
DOI: 10.3969/j.issn.1673-548X.2015.01.036
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作者单位
朱杰 314200 浙江省平湖市第一人民医院检验科 
孙红 314200 浙江省平湖市第一人民医院检验科 
蒋中英 314200 浙江省平湖市第一人民医院检验科 
张高峰 314200 浙江省平湖市第一人民医院检验科 
马雅英 314200 浙江省平湖市第一人民医院检验科 
中文摘要:目的 观察肝素结合蛋白(HBP)在急性冠脉综合征(ACS)患者血浆中的变化,探讨其在ST段抬高性急性心肌梗死(STEAMI)预测和预后评价中的意义。方法 分别测定47例STEAMI、33例非ST段抬高性急性冠脉综合征(NSTEACS),32例稳定型心绞痛(SAP)患者和35例健康人员HBP和肌钙蛋白I(TnI)浓度,分析二者的相关性,并以ROC曲线评价HBP和TnI对STEAMI的诊断价值。结果 NSTEACS组HBP和TnI水平均显著高于SAP组和正常对照组(P=0.000),但显著低于STEAMI组(P=0.000)。NSTEACS组和STEAMI组HBP与TnI均呈显著正相关(r=0.778和0.797,P<0.01)。HBP和TnI在STEAMI中的ROC曲线下面积分别为0.937(95%CI:0.889~0.986)和0.912(95%CI:0.852~0.973);HBP诊断界值为8.55ng/ml,敏感度为89.4%,特异性为75.8%。STEAMI死亡组治疗前HBP水平和阳性率均显著高于存活组(P<0.01),但两组TnI水平和阳性率差异无统计学意义(P>0.05)。结论 HBP可作为预测STEAMI的敏感指标,并对STEAMI患者的预后评价具有重要意义。
中文关键词:肝素结合蛋白  ST段抬高性急性心肌梗死  诊断  预后评价
 
Clinical Significance of Heparin-binding Protein in Patients with ST-segment Elevated Acute Myocardial Infarction
Abstract:Objective To observe the alteration of heparin-binding protein(HBP) in patients with acute coronary syndrome(ACS), and to explore its clinical significance in prediction and prognosis of ST segment elevated acute myocardial infarction(STEAMI). Methods Forty-seven patients with STEAMI, 33 patients with NSTEACS, 32 patients with stable angina pectoris (SAP), and 35 healthy volunteers were involved. HBP and troponin I (TnI) were measured. The correlation between HBP and TnI was analyzed. And the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of HBP and TnI in STEAMI. Results At group NSTEACS, levels of HBP and TnI were significantly higher than those at group SAP and group healthy volunteers, but were significantly lower than those at group STEAMI(P<0.001). There was sinificantly positive correlation between HBP and TnI at group NSTEACS and STEAMI(P<0.001). The area under ROC curve of HBP and TnI in STEAMI was 0.937,95%CI:0.889-0.986 and 0.912,95%CI:0.852-0.973, respectively. With the optimal cutoff value of 8.55ng/ml for HBP, the sensitivity and specificity was 89.4% and 75.8%, respectively. HBP level and positive rate at group STEAMI non-survival was notably higher than that at group survival (P<0.001),but there was no significantly difference for TnI level and positive rate between the two groups(P>0.05). Conclusion HBP is a more sensitive marker for the prediction of ST-segment elevated acute myocardial infarction.There is important significance for HBP in prognosis evaluation of STEAMI patients.
keywords:Heparin binding protein  ST-segment elevated acute myocardial infarction  Diagnosis  Prognosis evaluation
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