心电图联合脑钠肽前体、肌钙蛋白T对早期急性心肌梗死的诊断价值

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摘要目的探究心电图（ECG）联合N端脑钠肽前体（NT-proBNP）、肌钙蛋白（cTnT）对早期急性心肌梗死（AMI）的诊断价值。方法选择2018年1月至2019年9月安徽省安庆市第一人民医院收治的132例因胸痛入院、疑似早期AMI患者作为研究对象。根据冠状动脉造影检查结果将其分为AMI组（85例）和非AMI组（47例）。所有患者均接受ECG检查，并对其血清NT-proBNP、cTnT水平进行测定。比较两组ECG检查结果和NT-proBNP、cTnT水平。绘制ECG+NT-proBNP、ECG+cTnT、ECG+NT-proBNP+cTnT在早期诊断AMI上的受试者工作特征曲线，并比较其诊断效能。结果两组ECG检查符合率比较，差异无统计学意义（P ＞ 0.05）。AMI组NT-proBNP、cTnT水平均高于非AMI组，差异有统计学意义（P ＜ 0.05）。ECG+NT-proBNP+cTnT诊断早期AMI的曲线下面积（0.874），明显高于ECG+NT-proBNP、ECG+cTnT的曲线下面积（分别为0.817、0.821），差异有统计学意义（P ＜ 0.05）。结论 ECG结合血清学指标NT-proBNP、cTnT能够显著提高早期急性心肌梗死的诊断准确率，在急性心肌梗死的早期筛查、诊断和治疗中具有较高的临床应用价值。

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	曹亮亮严卫国

关键词 ：早期急性心肌梗死, 心电图, 脑钠肽前体, 肌钙蛋白T, 诊断价值

Abstract：Objective To research the diagnostic value of electrocardiographic (ECG) combined with N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) in early acute myocardial infarction (AMI). Methods A total of 132 patients with chest pain and suspected early AMI admitted to the the First People’s Hospital of Anqing City, Anhui Province from January 2018 to September 2019 were selected as the research objects. According to the results of coronary angiography, they were divided into AMI group (85 cases) and non AMI group (47 cases). All patients underwent ECG, and their serum NT-proBNP and cTnT levels were measured. The ECG results, NT-proBNP and cTnT levels of the two groups were compared. The receiver operating characteristic curves of ECG + NT-proBNP, ECG + cTnT and ECG + NT-proBNP + cTnT in the diagnosis of early AMI were drawed, and their diagnostic efficacy were compared. Results There was no significant difference in the coincidence rate of ECG examination between the two groups (P ＞ 0.05). The levels of NT-proBNP and cTnT in AMI group were higher than those in non AMI group, the differences were statistically significant (P ＜ 0.05). The area under curve of ECG + NT-proBNP + cTnT in the diagnosis of early AMI (0.874) was higher than that of ECG + NT-proBNP and ECG + cTnT (0.817, 0.821, respectively), the differences were statistically significant (P ＜ 0.05). Conclusion ECG combined with serological indexes NT-proBNP and cTnT can significantly improve the diagnostic accuracy of early acute myocardial infarction, and has high clinical application value in early screening, diagnosis and treatment of acute myocardial infarction.

Key words： Early acute myocardial infarction Electrocardiographic Pro-brain natriuretic peptide Cardiac troponin T Diagnostic value

引用本文:

曹亮亮严卫国. 心电图联合脑钠肽前体、肌钙蛋白T对早期急性心肌梗死的诊断价值[J]. 中国医药导报, 2022, 19(2): 67-70.
CAO Liangliang YAN Weiguo. Diagnostic value of electrocardiogram combined with pro-brain natriuretic peptide precursor and cardiac troponin T in early acute myocardial infarction. 中国医药导报, 2022, 19(2): 67-70.

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