CAJ | 학술논문

目的：探讨血清同型半胱氨酸检测水平对诊断急性心肌梗死的临床应用价值。方法选择2013年1～12月在该院确诊为急性心肌梗死的患者78例设为急性心肌梗死组，69例确诊为不稳定性心绞痛的患者设为不稳定性心绞痛组，选择同期来该院例行健康体检者78例为对照组，分别检测纳入对象血清中的同型半胱氨酸、肌红蛋白和肌酸激酶同工酶的浓度，对最终结果进行统计分析。结果急性心肌梗死组患者血清中同型半胱氨酸浓度和阳性率明显高于不稳定性心绞痛组（P＜0．05），肌红蛋白和肌酸激酶同工酶在浓度和阳性率方面比较差异无统计学意义（P＞0．05）；急性心肌梗死组和不稳定性心绞痛组患者的同型半胱氨酸浓度和阳性率均明显高于对照组（ P＜0．05）；ROC曲线分析可见，对于急性心肌梗死疾病的诊断效率由高到低依次为肌红蛋白、同型半胱氨酸、肌酸激酶同工酶。结论血清同型半胱氨酸可作为诊断急性心肌梗死的常规检测指标，对患者的病情监控和预后都有一定的临床价值，对于急性心肌梗死和不稳定性心绞痛的鉴别诊断也有一定的临床意义。
목적：탐토혈청동형반광안산검측수평대진단급성심기경사적림상응용개치。방법선택2013년1～12월재해원학진위급성심기경사적환자78례설위급성심기경사조，69례학진위불은정성심교통적환자설위불은정성심교통조，선택동기래해원례행건강체검자78례위대조조，분별검측납입대상혈청중적동형반광안산、기홍단백화기산격매동공매적농도，대최종결과진행통계분석。결과급성심기경사조환자혈청중동형반광안산농도화양성솔명현고우불은정성심교통조（P＜0．05），기홍단백화기산격매동공매재농도화양성솔방면비교차이무통계학의의（P＞0．05）；급성심기경사조화불은정성심교통조환자적동형반광안산농도화양성솔균명현고우대조조（ P＜0．05）；ROC곡선분석가견，대우급성심기경사질병적진단효솔유고도저의차위기홍단백、동형반광안산、기산격매동공매。결론혈청동형반광안산가작위진단급성심기경사적상규검측지표，대환자적병정감공화예후도유일정적림상개치，대우급성심기경사화불은정성심교통적감별진단야유일정적림상의의。
Objective To analyze the clinical application value of serum homocysteine(Hcy) detection in diagnosing acute myo-cardial infarction .Methods 78 cases of acute myocardial infarction in the hospital from January to December 2013 were selected as the acute myocardial infarction group ,69 cases of unstable angina as the unstable angina group and contemporaneous 78 healthy per-sons undergoing the physical examination as the control group .The serum Hcy ,myoglobin and creatine kinase isoenzyme were de-tected and the detection results were performed the statistical analysis .Results The serum Hcy levels and the positive rate in the a-cute myocardial infarction group were significantly higher than those in the unstable angina group (P<0 .05) ,but serum myoglobin and creatine kinase isoenzyme had no statistical differences in the concentration and positive rate between these two groups (P>0 .05) .The serum Hcy concentration and the positive rate in the acute myocardial infarction group and the unstable angina group were higher than those in the control group(P<0 .05) .The ROC curve analysis showed that the efficiency for diagnosing acute my-ocardial infarction from high to low in turn was MYO ,Hcy and CK-MB .Conclusion Serum Hcy may be used as a routine index for diagnosing acute myocardial infarction ,which has certain clinical value for the condition monitoring and prognosis of the disease ,and also has certain clinical significance for the differential diagnosis between acute myocardial infarction and unstable angina .