和肽素、肌钙蛋白Ｉ在ACS早期诊断中的临床意义

Significance of copeptin and cardiac troponin I in early diagnosis of acute coronary syndrome

摘要:

目的 研究联合检测血浆和肽素（copeptin）、心肌肌钙蛋白I（cTnI）在急性冠状动脉综合征（ACS）早期诊断中的临床意义。方法 选择心前区疼痛3 h 内的急诊患者120 例为研究对象，分别抽取静脉血检测copeptin、肌酸激酶同工酶（CK-MB）及cTnI，同时行心电图（ECG）检查，以同期健康体检者100 例为对照组。评价各项检测指标诊断ACS 的特异性和敏感性。结果 与对照组相比，ACS 组血浆copeptin 的水平升高（P <0.05），其敏感性为80.68%，高于ECG、CK-MB、cTnI，检测copeptin+cTnI 的敏感性为56.47%（48/85），但特异性为92.10%（35/38），阴性预测值92.17%，且对ACS 的诊断率高达85%。结论 copeptin 对ACS 的早期诊断性能优于单一检测ECG、CK-MB 及cTnI，而联合检测血浆copeptin、cTnI 的阴性预测值和诊断率高，有助于临床上更好地对ACS 做出早期诊断。

Abstract:

Objective To evaluate the clinical significance of combined detection of serum copeptin and cardiac troponin I (cTnI) in early diagnosis of acute coronary syndrome (ACS). Methods Serum levels of copeptin, creatine kinase isoenzyme (CK-MB) and cTnI were detected in 120 patients suffered with acute chest pain within 3 hours and in 100 healthy control subjects. Electrocardiography (ECG) was also performed for each subject. The sensitivity and specificity of these indicators for the diagnosis of ACS were evaluated. Results Being compared with the control group, the plasma copeptin level was increased in the ACS patients (P < 0.05), its sensitivity was 80.68%, higher than that of ECG, CK-MB and cTnI (P < 0.05). The sensitivity of combined detection of copeptin and cTnI was 56.47%(48/85), but its specificity was 92.10% (35/38), its negative predictive value was 92.17%, and the diagnosis rate of ACS was 85%. Conclusions For early diagnosis of ACS, copeptin is better than ECG, CK-MB and cTnI alone, but combined detection of copeptin and cTnI is an effective tool for early diagnosis of ACS.