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降钙素原评价急性冠脉综合征的临床研究 被引量：4

Clinical research on the evaluation of procalcitonin in acute coronary syndrome
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摘要 目的：探讨降钙素原（ PCT）评价急性冠脉综合征的临床意义。方法：通过对急诊141例缺血性胸痛患者进行心肌标志物的测定，观察患者心脏不良事件（ MACE）发生率及死亡率，并进一步比较PCT与其他心肌标志物，如肌钙蛋白T（Tn-T）、肌酸磷酸激酶同工酶（CK-MB）、肌红蛋白及超敏C反应蛋白（Hs-CRP）在评价急性冠脉综合征中的临床意义。结果：PCT诊断心肌梗死敏感性为38.3％（95％CI 28.8％～47.3％），特异性为77.8％（95％CI 70.0％～84.4％），阳性似然比[LR（＋）]1.725，阴性似然比[LR（-）]0.792；复测PCT敏感性、特异性、LR （＋）及LR （-）分别为90.0％（95％CI 80.9％～95.7％）、59.3％（95％CI 52.5％～63.5％）、2.2及0.16。 PCT评价MACE、住院期间死亡率及自入院后1个月内、6个月内的死亡率敏感性及特异性分别为81.3％（95％CI 54％～95％）/40.8％（95％CI 32％～49％）、66.7％（95％CI 13％～98％）/38.4％（95％CI 30％～47％）、50％（95％CI 9％～90％）/38％（95％CI 30％～47％）、60％（95％CI 17％～92％）/38.2％（95％CI 30％～47％）。结论：对以缺血性胸痛为主要表现的患者来说，PCT不是诊断急性冠脉综合征有效的标志物，且对心肌梗死预后无准确的评价意义。 Objective：To investigate the evaluation effect of procalcitonin （PCT） on acute coronary syndrome. Methods：141 patients with chemic chest pain in the emergency department were chosen to test the cardiac markers, and evaluate the incidence of adverse cardiac events and mortality rate .Furthermore, the clinical significances of PCT were compared with other cardiac markers （ Tn-T, CK-MB, myoglobin and Hs-CRP） in the evaluation of acute coronary syndrome .Results：PCT to identify myocardial infarction in patients with chest pain of presumed ischemic origin had a sensitivity of 38.3%（95%CI 28.8%-47.3%） and a specificity of 77.8%（95%CI 70.0%-84.4%） , a positive likelihood ratio （ LR ＋） of 1.725 and a negative likelihood ratio （ LR -） of 0.792.The 4th hour diagnostic values （sensitivity, specificity, LR＋and LR-） of procalcitonin were 90%（95%CI 80.9%-95.7%）, 59.3%（95%CI 52.5%-63.5%）, 2.2, and 0.16, respectively.Sensitivity and specificity of PCT in evaluating MACE and hospital , after 1 month, 6 month mortality were 81.3% （95%CI 54%-95%）/95%（95%CI 32%-49%）, 95%（95%CI 13%-98%）/38.4%（95%CI 30%-47%）,47%（95%CI 9%-90%）/38%（95%CI 30%-47%）,47%（95%CI 17%-92%）/38.2%（95%CI 30%-47%）.Conclusion： For patients with chemic chest pain as the main performance , PCT is not an effective marker of myocardial infarction , and no sense of accurate evaluation of the prognosis of myocardial infarction .
作者 张淑伟 刘卫云 章德本
机构地区 承德市双滦区人民医院心内科 承德护理职业学院 承德市双滦区人民医院急诊科
出处 《东南大学学报（医学版）》 CAS 2014年第3期287-290,共4页 Journal of Southeast University(Medical Science Edition)
关键词 降钙素原 心肌梗死 肌酸磷酸激酶同工酶 肌红蛋白 超敏C反应蛋白 procalcitonin myocardial infarction creative kinase MB myoglobin high sensitive C-reactive protein
分类号 R514.4 [医药卫生—内科学]
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参考文献9

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同被引文献43

  • 1周俊,余意君,吴师伟.胱抑素C、IL-6在老年急性心肌梗死预后判定中的意义[J].中国老年学杂志,2014,34(12):3229-3230. 被引量：8
  • 2Manoharan G,Ntalianis A,Muller O,et al.Severity of coronary arterial stenoses responsible for acute coronary syndromes[J].Am J Cardiol,2009;103(9):1183-8.
  • 3Topol EJ,Teirstein PS.Textbook of interventional cardiology[M].7thed Canada:Elsevier,2015:117-31.
  • 4Sinclair H,Bourantas C,Bagnall A et al.Oct for the identification of vulnerable plaque in acute coronary syndrome[J].JACC Cardiovasc Imaging,2015;8(2):198-209.
  • 5Xie Y,Mintz GS,Yang J,et al.Clinical outcome of nonculprit plaque ruptures in patients with acute coronary syndrome in the prospect study[J]JACC Cardiovasc Imaging,2014;7(4):397-405.
  • 6Braunwald E.Progress in the noninvasive detection of high-risk coronary plaques[J].J Am Coll Cardiol,2015;66(4):347-9.
  • 7Mintz GS,Nissen SE,Anderson WD,et al.American college of cardiology clinical expert consensus document on standards for acquisition,measurement and reporting of intravascular ultrasound studies(ivus).A report o the american college of cardiology task force on clinical expert consensus documents[J].J Am Coll Cardiol,2001;37(15):1478-92.
  • 8Hong MK,Mintz GS,Lee CW,et al.Comparison of coronary plaque rupture between stable angina and acute myocardial infarction:A three-vesse intravascular ultrasound study in 235 patients[J].Circulation,2004;110(8):928-33.
  • 9Nicholls SJ,Sipahi I.Emerging role of intravascular ultrasound in the assessment of experimental anti-atherosclerotic therapies[J].Curr Med Chem,2006;13(15):1727-34.
  • 10Assicot M,Gendrel D,Carsin H,et al.High serum procalcitonin concentrations in patients with sepsis and infection[J].Lancet,1993;341(8844):515-8.

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东南大学学报（医学版）
2014年 第3期

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