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目的探讨血清肌钙蛋白及脑钠肽检测在非ST段抬高型急性(冠状动脉)综合征(ACS)及合并心力衰竭(心衰)鉴别诊断中的临床应用价值。方法 43例非ST段抬高型ACS患者为观察组,其中19例非ST段抬高型ACS合并慢性心衰为观察组1,24例非ST段抬高型ACS非慢性心衰为观察组2;同期50例健康体检者为对照组,分析患者血清肌钙蛋白(cTn)、脑钠肽(BNP)及心肌酶的检测结果。结果观察组肌酸激酶(CK)、cTn及磷酸肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LHD)、天冬氨酸氨基转移酶(AST)、α-羟基丁酸脱氢酶(HBDH)高于对照组,差异有统计学意义(P<0.05)。观察组2 BNP为(961.0±171.8)pg/ml高于观察组1的(79.0±19.8)pg/ml,差异有统计学意义(P<0.05)。观察组BNP高于对照组的(39.0±10.2)pg/ml,差异有统计学意义(P<0.05)。结论 cTn及CK-MB对非ST段抬高型ACS有较高的敏感性及特异性;BNP对诊断ACS合并慢性心衰有意义,值得临床推广。
Objective To investigate the clinical value of serum troponin and brain natriuretic peptide in the differential diagnosis of non-ST segment elevation acute coronary syndrome (ACS) and heart failure complicated with heart failure. Methods Forty-three patients with non-ST elevation ACS were enrolled in this study. Twenty-nine non-ST-elevation ACS patients with chronic heart failure were observed in the study group, and 24 non-ST-segment elevation ACS patients 2; In the same period, 50 healthy controls were used as the control group to analyze the results of serum cTn, BNP and myocardial enzymes. Results The levels of creatine kinase (CK), cTn and creatine phosphokinase (CK-MB), lactate dehydrogenase (LHD), aspartate aminotransferase (AST) Hydrogenase (HBDH) higher than the control group, the difference was statistically significant (P <0.05). The BNP level of observation group 2 was significantly higher than that of observation group 1 (961.0 ± 171.8 pg / ml vs 79.0 ± 19.8 pg / ml, P <0.05). The BNP level in the observation group was significantly higher than that in the control group (39.0 ± 10.2) pg / ml (P <0.05). Conclusions cTn and CK-MB have high sensitivity and specificity for non-ST segment elevation ACS. BNP is of clinical significance in diagnosis of ACS complicated with chronic heart failure.