摘要
目的:探讨超声心动图(UCG)联合心肌损伤标志物对急性心肌梗死(AMI)的诊断效能及不良预后的预测价值。方法:选取某院2022年2月—2023年7月收治的100例AMI患者为病例组,所有患者均接受经皮冠脉介入术(PCI)治疗,根据术后随访1年是否发生心血管不良事件(MACE)分为预后不良组(n=20)和预后良好组(n=80)。另选取同期接受健康体检的30例健康志愿者为对照组。比较病例组与对照组及不同预后患者UCG参数[左室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)]及心肌损伤标志物[肌红蛋白(MYO)、心肌肌钙蛋白(cTnT)、肌酸激酶同工酶(CK-MB)]水平。统计UCG、心肌损伤标志物对AMI的诊断准确率、敏感度、特异度。绘制受试者工作特征(ROC)曲线评估UCG参数、心肌损伤标志物对AMI患者PCI术后发生不良预后的预测价值。结果:病例组LVEF低于对照组,LVEDV、LVESV、MYO、cTnT、CK-MB高于对照组,差异有统计学意义(P<0.05)。UCG与冠脉造影诊断结果一致性中等(k=0.522);心肌损伤标志物与冠脉造影诊断结果一致性较高(k=0.629);二者联合与冠脉造影诊断结果几乎完全一致(k=0.844)。UCG联合心肌损伤标志物对AMI的诊断准确率、敏感度、特异度分别为87.69%、88.00%、86.67%。预后不良组LVEF低于预后良好组,LVEDV、LVESV、MYO、cTnT、CK-MB高于预后良好组,差异有统计学意义(P<0.05)。ROC分析显示,UCG参数、心肌损伤标志物预测AMI患者PCI术后发生不良预后的AUC分别为0.853、0.852;二者联合检测的AUC为0.859,灵敏度、特异度分别为83.06%、79.25%。结论:UCG参数联合心肌损伤标志物能实现对AMI患者的早期诊断,对不良预后有一定的预测价值。
Objective:To analyze the diagnostic efficacy of ultrasonic cardiogram(UCG)combined with myocardial injury markers for acute myocardial infarction(AMI)and its predictive value for poor prognosis in patients.Methods:A retrospective study was conducted on 100 patients with AMI admitted to a hospital from February 2022 to July 2023,as well as 30 healthy volunteers who underwent echocardiography and laboratory tests during the same period.They were divided into a case group and a control group,and the differences in echocardiography parameters and myocardial injury markers between the two groups were compared.According to whether major adverse cardiovascular events(MACE)occurred during the 1-year follow-up after surgery,the patients in the case group were re-divided into a poor prognosis group(n=20)and a good prognosis group(n=80).Differences in UCG parameters and myocardial injury markers among patients with different prognoses were compared and verified.UCG and myocardial injury markers for the accuracy,sensitivity,and specificity of AMI diagnosis were statistically analyzed.Receiver Operating Characteristic(ROC)curves were plotted to evaluate the predictive value of UCG parameters and myocardial injury markers for adverse prognosis in AMI patients after PCI.Results:The left ventricular ejection fraction(LVEF)of the case group was lower than that of the control group and the good prognosis group,and left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),as well as the levels of MYO,cTnT,and CK-MB in the case group were higher than those in the control group and the good prognosis group(P<0.05).The diagnostic accuracy,sensitivity,and specificity of UCG combined with myocardial injury markers for AMI were 87.69%,88.00%,and 86.67%,respectively.ROC analysis showed that the AUC of UCG parameters and myocardial injury markers for predicting adverse prognosis in AMI patients after PCI were 0.853 and 0.852.The combination of UCG and myocardial injury markers has higher sensitivity and specificity in predicting poor prognosis of AMI than UCG alone and myocardial injury markers alone.Conclusion:UCG combined with myocardial injury markers can diagnose AMI early and achieve early prediction of poor prognosis in patients.
作者
杨芳娟
蔡琦
YANG Fangjuan;CAI Qi(Department of Ultrasound,The Hospital of Traditional Chinese Medicine of Lingbao City,Lingbao,Henan 472500,China)
出处
《淮海医药》
2025年第4期336-340,共5页
Journal of Huaihai Medicine
基金
河南省医学科技攻关项目(LHGJ2019010124)。
关键词
急性心肌梗死
超声心动图
心肌损伤标志物
诊断效能
不良预后
Acute myocardial infarction
Echocardiography
Myocardial injury markers
Diagnostic efficacy
Poor prognosis
