摘要
目的 观察三维超声心动图联合血清心脏肌球蛋白结合蛋白C、肌钙蛋白诊断急性心肌梗死的价值。方法 选取2020年1月-2023年1月于乐山市人民医院治疗的150例AMI的患者为研究对象(AMI组),另选同期于本院进行体检的100名健康者设为对照组。比较2组三维超声心电图指标、血清cMyBP-C、cTnⅠ;通过ROC分析三维超声心动图、血清cMyBP-C、cTnⅠ诊断AMI的价值;分析三维超声心动图联合血清cMyBP-C、cTnⅠ诊断AMI的价值。结果 AMI组LEVDV、LVESV高于对照组,LVEF低于对照组(P<0.05);AMI组cMyBP-C、cTnⅠ高于对照组(P<0.05);经ROC分析证实三维超声心动图、血清cMyBP-C、cTnⅠ均能用于诊断AMI中,曲线下面积分别为0.908、0.766、0.979、0.970、0.978,且P<0.05;以LEVDV≥96.22 mL、LVESV≥53.195 mL、LVEF≤58.44%、cMyBP-C≥55.44 μg·L^(-1)、cTnⅠ≥1.395 pg·L^(-1)定义为阳性,联合诊断时任一结果为阳性则联合诊断视为阳性。经一致性分析证实,三维超声心动图联合血清cMyBP-C、cTnⅠ诊断AMI的准确率97.33%、灵敏度97.81%、特异度92.31%、阳性预测值99.26%、阴性预测值80.00%、Kappa值=0.843。结论 三维超声心动图与血清cMyBP-C、cTnⅠ均可用于诊断AMI,但联合应用时的敏感度更高,可进一步提高诊断结果的客观性以及准确率,减少漏诊、误诊情况的发生,另检测以上指标的操作方法无创且更加便捷,利于医师动态监测患者病情,可为临床诊治提供可靠依据,具有较高推广价值。
Objective To observe the value of three-dimensional echocardiography combined with serum cardiac myosin-binding protein C(cMyBP-C)and troponin(cTnⅠ)in the diagnosis of acute myocardial infarction(AMI).Methods A total of 150 patients with AMI who received treatment in Leshan People's Hospital from January 2020 to January 2023 were selected as the study objects(AMI group),and 100 healthy subjects who underwent physical examination in our hospital during the same period were selected as the control group.The value of three-dimensional ultrasound echocardiogram indicators,and levels of serum cMyBP-C and cTn I in two groups were compared.The value of three-dimensional echocardiography,levels of serum cMyBP-C and cTnⅠin the diagnosis of AMI using receiver operating characteristic curve(ROC curve)were analyzed.The value of three-dimensional echocardiography combined with levels of serum cMyBP-C and cTnⅠin the diagnosis of AMI was analyzed.Results Left ventricular end diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)in AMI group were higher than those in the control group,while left ventricular ejection fraction(LVEF)in AMI group was lower than that in the control group(P<0.05).The levels of cMyBP-C and cTnⅠof AMI group were higher than those of the control group(P<0.05).ROC analysis confirmed that three-dimensional echocardiography,levels of serum cMyBP-C and cTnⅠcould be used in the diagnosis of AMI,and the areas under the curve were 0.908,0.766,0.979,0.970,and 0.978,respectively,and P<0.05.LEVDV≥96.22mL,LVESV≥53.195mL,LVEF≤58.44%,cMyBP-C≥55.44μg·L^(-1),cTnⅠ≥1.395pg·L^(-1) were defined as positive;When the combined diagnosis was made,if any result was positive,the combined diagnosis was considered positive.Consistency analysis showed that the accuracy,sensitivity,specificity,positive predictive value,negative predictive value and Kappa value of three-dimensional echocardiography combined wth serum serum cMyBP-C and cTnⅠin the diagnosis of AMI were 97.33%,97.81%,92.31%,99.26%,80.00%and 0.843,respectively.Conclusion Three dimensional echocardiography,serum cMyBP-C and cTnⅠcan be used for the diagnosis of AMI,but the sensitivity is higher when used in combination,which can further improve the objectivity and accuracy of the diagnosis results,and reduce the occurrence of missed diagnosis and misdiagnosis.In addition,the operation method of detecting the above indexes is non-invasive and more convenient,which is conducive to doctors dynamically monitoring of patients'conditions.It can provide reliable basis for clinical diagnosis and treatment and has high promotion value.
作者
刘影
李超
王淙锦
马瑞
LIU Ying;LI Chao;WANG Congjin;MA Rui(Department of Ultrasound Medicine,Leshan People's Hospital,Leshan 614000,China)
出处
《长春中医药大学学报》
2025年第3期313-317,共5页
Journal of Changchun University of Chinese Medicine
基金
四川省卫生健康委员科研课题(20PJ292)。
关键词
三维超声心动图
心脏肌球蛋白结合蛋白C
肌钙蛋白
急性心肌梗死
诊断价值
three-dimensional echocardiography
cardiac myosin-binding protein C
troponin
acute myocardial infarction
diagnostic value
