CAJ | 학술논문

目的：探讨和肽素（copeptin）和心肌肌钙蛋白I（cTnI）、高敏心肌肌钙蛋白T（hs-TnT）联合检测时对急性心肌梗死（AMI）的诊断价值。方法 AMI患者152例（AMI组），同期健康体检者143例（对照组）。（1）考察2组0、4、6及12 h copeptin、cTnI及hs-TnT水平差异。（2）对2组行copeptin与cTnI联合检测（cop/cTnI）、copeptin与hs-TnT联合检测（cop/hs-TnT）。考察AMI组发病后不同时间点上述不同检测指标阳性检出率情况。（3）判断发病即刻各种心肌标志物对AMI诊断的敏感度、特异度及准确度。结果（1）2组copeptin在发病0、4、6和12 h时差异有统计学意义（P<0.05）。2组cTnI与hs-TnT在0 h时差异无统计学意义。（2）cop/cTnI和cop/hs-TnT联合检测组在不同发病时刻较各自单独检测均具有更高的阳性检出率。（3）cop/cTnI和cop/hs-TnT联合检测的敏感度、特异度以及准确度均高于其单独检测。cop/hs-TnT联合检测最佳。结论 cop/cTnI和cop/hs-TnT联合检测在AMI发病早期即具有较高的敏感度、特异度和准确度，在临床疾病诊断中具有很好的应用价值。
목적：탐토화태소（copeptin）화심기기개단백I（cTnI）、고민심기기개단백T（hs-TnT）연합검측시대급성심기경사（AMI）적진단개치。방법 AMI환자152례（AMI조），동기건강체검자143례（대조조）。（1）고찰2조0、4、6급12 h copeptin、cTnI급hs-TnT수평차이。（2）대2조행copeptin여cTnI연합검측（cop/cTnI）、copeptin여hs-TnT연합검측（cop/hs-TnT）。고찰AMI조발병후불동시간점상술불동검측지표양성검출솔정황。（3）판단발병즉각각충심기표지물대AMI진단적민감도、특이도급준학도。결과（1）2조copeptin재발병0、4、6화12 h시차이유통계학의의（P<0.05）。2조cTnI여hs-TnT재0 h시차이무통계학의의。（2）cop/cTnI화cop/hs-TnT연합검측조재불동발병시각교각자단독검측균구유경고적양성검출솔。（3）cop/cTnI화cop/hs-TnT연합검측적민감도、특이도이급준학도균고우기단독검측。cop/hs-TnT연합검측최가。결론 cop/cTnI화cop/hs-TnT연합검측재AMI발병조기즉구유교고적민감도、특이도화준학도，재림상질병진단중구유흔호적응용개치。
Objective To investigate the diagnostic value of combined copeptin, cardiac troponin I (cTnI) and high sen?sitive cardiac troponin T (hs-TnT) in determination of acute myocardial infarction (AMI). Methods A total of 152 patients with AMI were selected as AMI group and 143 healthy examinees during the same period were selected as control group. (1) The levels of copeptin, cTnI and hs-TnT were detected at 0, 4, 6 and 12 h in two groups. (2) The combined detection of cop/cTnI and cop/hs-TnT were studied. The positive rates of these items were evaluated at different time points of AMI. ( 3) The diagnostic sensitivity, specificity and accuracy of different cardiac biomarkers for AMI were compared. Results (1) There were significant differences in copeptin at 0, 4, 6 and 12 h between two groups (P<0.05). There were no significant differ?ences in cTnI and hs-TnT between two groups. (2) cop/cTnI and cop/hs-TnT combined detection showed better positive rates than those of copeptin, cTnI or hs-TnT detection alone. (3) In addition, the combined detection of cop/cTnI and cop/cTnI improved significantly the diagnostic sensitivity of AMI. Compared to cop/cTnI combination, cop/hs-TnT combination detec?tion showed better diagnostic sensitivity, specificity and accuracy for AMI. Conclusion The combined detection of cop/cTnI and cop/hs-TnT are very helpful for early diagnosis of AMI, which shows a very good diagnostic value in clinical application.