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目的探讨和肽素(Copeptin)、肌钙蛋白Ⅰ(cTnI)及其联合检测在早期急性心肌梗死(AMI)中的诊断价值。方法选取宁夏回族自治区人民医院2015年7—12月收治的“持续性胸痛4 h”患者132例,根据冠状动脉造影术(CAG)检查分为正常组(n=42)和AMI组(n=90)。检测比较两组患者Copeptin、cTnI水平,并分析Copeptin、cTnI及其联合检测在早期AMI中的诊断价值。结果 AMI组患者胸痛后4 h、6 h Copeptin和cTnI水平高于正常组(P<0.05)。以CAG结果为金标准,Copeptin联合cTnI检测的灵敏度为96.67%,特异度为80.95%,阳性预测值为91.58%,阴性预测值为91.89%,准确度为91.67%;单独Copeptin检测的灵敏度为91.11%,特异度为57.14%,阳性预测值为82.00%,阴性预测值为75.00%,准确度80.30%;单独cTnI检测的灵敏度为75.56%,特异度为71.43%,阳性预测值为85.00%,阴性预测值为57.69%,准确度为74.24%。结论患者胸痛4 h内,Copeptin联合cTnI检测有助于急诊AMI的快速筛选,提高AMI早期诊断率。
Objective To investigate the diagnostic value of Copeptin, cTnI and their combined detection in patients with early acute myocardial infarction (AMI). Methods 132 cases of “persistent chest pain 4 h” admitted to People’s Hospital of Ningxia Hui Autonomous Region from July to December in 2015 were divided into normal group (n = 42) and AMI group according to coronary angiography (CAG) n = 90). The levels of Copeptin and cTnI in both groups were detected and compared, and the diagnostic value of Copeptin, cTnI and their combined detection in early AMI was analyzed. Results The levels of Copeptin and cTnI in AMI group were significantly higher than those in normal group at 4 h and 6 h after chest pain (P <0.05). The sensitivity of Copeptin in combination with cTnI was 96.67%, the specificity was 80.95%, the positive predictive value was 91.58%, the negative predictive value was 91.89% and the accuracy was 91.67%. The sensitivity of Copeptin alone was 91.11 %, The specificity was 57.14%, the positive predictive value was 82.00%, the negative predictive value was 75.00% and the accuracy was 80.30%. The sensitivity of single cTnI assay was 75.56%, the specificity was 71.43%, the positive predictive value was 85.00% The predicted value is 57.69% and the accuracy is 74.24%. Conclusion Within 4 h of chest pain, Copeptin combined with cTnI is helpful for the rapid screening of emergency AMI and improving the early diagnosis rate of AMI.