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目的:探讨同型半胱氨酸(Hcy)和红细胞体积分布宽度变异系数(RDW CV)联合检测对急性心肌梗死(AMI)的诊断价值。方法:收集我院2012年1月到2013年6月冠心病患者300例,其中心绞痛121例、缺血性心力衰竭65例、AMI例114例。同期收集我院体检正常者100例为对照组,利用全自动细胞分析仪和免疫法分别测定Hcy和RDW CV,分析二者联合对AMI诊断价值。结果:Hcy与RDW CV水平在四组的差别具有统计学意义(P<0.05),其中AMI组中Hcy与RDW CV水平明显高于其他三组水平,差异具有统计学意义(P<0.05);Hcy、RDW CV以及二者联合诊断AMI组阳性率之间差别具有统计学意义(P<0.05),对对照组的检测阳性率差异无统计学意义(P>0.05);Hcy单独检测灵敏度和特异度分别为68.42%、86.00%,RDW CV单独检测灵敏度和特异度分别为64.91%、84.00%,联合检测灵敏度和特异度分别为83.33%、93.00%,差异具有统计学意义(P<0.05),联合检测的一致率、阳性预测值、阴性预测值分别为87.85%、93.14%、83.04%。结论:Hcy联合RDW CV诊断AMI具有相对较高的灵敏度、特异度、一致率、阳性预测值和阴性预测值。
Objective: To investigate the diagnostic value of homocysteine (Hcy) combined with RDW CV in the diagnosis of acute myocardial infarction (AMI). Methods: From January 2012 to June 2013 in our hospital, 300 patients with coronary heart disease were collected, including 121 cases of angina pectoris, 65 cases of ischemic heart failure and 114 cases of AMI. In the same period, 100 normal subjects in our hospital were collected as the control group. Hcy and RDW CV were measured by automatic cell analyzer and immunoassay, respectively. Results: The differences of Hcy and RDW CV between the four groups were statistically significant (P <0.05). The levels of Hcy and RDW CV in AMI group were significantly higher than those in the other three groups (P <0.05). The positive rates of Hcy, RDW CV and the combined diagnosis of the two groups were statistically significant (P <0.05), while there was no significant difference in the positive rate of the control group (P> 0.05). The sensitivity and specificity of Hcy alone The sensitivity and specificity of RDW CV were 64.91% and 84.00%, respectively. The sensitivity and specificity of combined detection were 83.33% and 93.00%, respectively, with statistical significance (P <0.05) The coincidence rate, positive predictive value and negative predictive value of combined testing were 87.85%, 93.14% and 83.04% respectively. Conclusions: Hcy combined with RDW CV has relatively high sensitivity, specificity, agreement rate, positive predictive value and negative predictive value in the diagnosis of AMI.