摘要
目的观察血清松驰素在急性心肌梗死突发患者中的诊断价值并比较不同血清松弛素水平对预后的影响。方法选取93例急性心肌梗死患者作为试验组,另选取100例健康志愿者作为对照组。对比2组血清松弛素水平,绘制受试者工作特征(ROC)曲线,确定血清松弛素在急性心肌梗死患者突发诊断中最佳节点,计算其敏感度、特异度和准确度。依据血清松弛素水平,将试验组患者再分为高水平组和低水平组,比较2组预后相关指标:左室舒张末期容积(LVEDV)、左室射血分数(LVEF)和舒张早期与舒张晚期的二尖瓣血流速度比值(E/A)水平,并对比心脏药物不良反应发生率(ADR)。结果试验组血清松弛素水平为(29.58±5.12)ng·mL^(-1),远高于对照组的(9.32±2.96)ng·mL^(-1),差异有统计学意义(P<0.05);血清松弛素水平在诊断急性心肌梗死突发中最佳节点为14.25 ng·mL^(-1),其中曲线下面积(AUC比值)为0.834,敏感度为80.65%,特异度为89.00%,准确度为84.97%。高松弛素组的LVEDV为(81.06±7.32)mL,明显低于低松弛素组的(95.38±7.82)mL,差异有统计学意义(P<0.05);高松弛素组LVEF为(55.89±6.21)%、E/A为1.19±0.21,明显高于低松弛素组LVEF值的(46.13±5.75)%和E/A值的0.85±0.23,差异有统计学意义(P<0.05);高松弛素组的ADR为3.85%,远低于低松弛素组的24.39%,差异有统计学意义(P<0.05)。结论血清松弛素在急性心肌梗死患者中明显升高,可用于心肌梗死的突发诊断和预后评估。
Objective To observe the diagnostic value of serum relaxin in the sudden- happened patient with acute myocardial infarction（ AMI）,and to compare effect on the prognosis at different serum relaxin levels. Methods Ninety-three cases of patients with AMI were selected as the treatment group,and another one hundred cases of healthy volunteers were selected as the control group. The levels of serum relaxin were compared between the two groups. Then the receiver operating characteristic（ ROC） curve was made. In order to make sure the best node of serum relaxin in the diagnosis of sudden- happened AMI. The sensitivity,specificity and accuracy were calculated. The patients in the treatment group were divided into high relaxin group and low relaxin group according to the levels of serum relaxin,and the indexes of prognosis such as the left ventricular end diastolic volume（ LVEDV）,leftventricular ejection fraction（ LVEF）,ratio of peak early to late diastolic filling velocity（ E / A）,were compared. The adverse drugs reaction（ ADR） was compared in two groups. Results The serum relaxin level in the treatment group was（ 29. 58 ± 5. 12） ng·mL-1far higher than that of（ 9. 32 ± 2. 96） ng·mL-1 in the control group（ P〈0. 05）.The best node of serum relaxin in the diagnosis of sudden- happened AMI was 14. 25 ng·mL-1. And area under the curve（ ratio of AUC） was 0. 834,with 80. 65% of sensitivity,89. 00% of specificity and 84. 97% of accuracy. The LVEDV was（ 81. 06 ± 7. 32） mL in the high relaxation group,significantly lower than that of（ 95. 38 ± 7. 82） mL in the low relaxation group（ P〈0. 05）. The LVEF and E / A in early and late diastolic of the former were（ 55. 89 ± 6. 21） % and 1. 19 ± 0. 21 in the high relaxation group,significantly higher than that of（ 46. 13 ± 5. 75） %and 0. 85 ± 0. 23 in the low relaxation group（ P〈0. 05）. The ADR in the high relaxation group was 3. 85%,far lower than that of 24. 39% in the low relaxation group（ P〈0. 05）. Conclusion The serum relaxin level in patients with AMI is obviously increased. it can be applied to burst diagnosis and prognosis assessment of myocardial infarction.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2017年第1期3-6,共4页
The Chinese Journal of Clinical Pharmacology
基金
山东省自然科学基金资助项目(2014ZRE27592)
关键词
血清松弛素
急性心肌梗死
预后
诊断价值
左室重构
serum relaxin
acute myocardial infarction
prognosis
diagnostic value
left ventricular remodeling
