肌钙蛋白T与N末端脑钠肽及D-二聚体对急性心肌梗死及早期胸痛患者的鉴别诊断.doc

肌钙蛋白T与N末端脑钠肽及D-二聚体对急性心肌梗死及早期胸痛患者的鉴别诊断


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　　[摘要]目的 通過联合检测全血肌钙蛋白T（cTnT）、N末端脑钠肽（NT-proBNP）及D-二聚体（D-D）的含量来鉴别诊断急性心肌梗死（AMI）及对早期胸痛患者的预后评估。方法 选取我院2018年3月～2019年10月急诊收治的157例胸痛患者为研究对象，根据筛选标准，将患者分为心源性胸痛组（n=88）和非心源性胸痛组（n=69），以健康志愿者作为对照组（n=46），所有研究对象都进行cTnT、NT-proBNP及D-D检测，同时跟进患者入院治疗后cTnT、NT-proBNP及D-D的变化趋势，进而评估患者的预后。结果 两组患者的cTnT、NT-proBNP及D-D高于健康组，差异有统计学意义（P<）;心源性胸痛组的cTnT和NT-proBNP水平高于非心源性胸痛组，差异有统计学意义（P<）;非心源性胸痛组D-D水平高于心源性胸痛组，差异有统计学意义（P<）。受试者工作特征曲线分析显示：全血cTnT、NT-proBNP及D-D水平的变化趋势可以用于胸痛患者的预后评估，各项指标的敏感度和特异度都较高。结论 cTnT、NT-proBNP及D-D联合检测可作为鉴别诊断胸痛患者为心源性还是非心源性胸痛的重要指标，同时对患者的预后评估有重要价值。
　　[关键词]肌钙蛋白T;N末端脑钠肽;D-二聚体，心源性胸痛;非心源性胸痛
　　[中图分类号] R44 [文献标识码] A [文章编号] 1674-4721（2020）8（c）-0161-04
　　[Abstract] Objective To differentially diagnose patients with acute myocardial infarction （AMI） and early chest pain by jointly detecting the contents of whole blood troponin T （cTnT）， N-terminal brain natriuretic peptide （NT-proBNP） and D-dimer（D-D） assessment of the patient′s prognosis. Methods A total of 157 patients with chest pain admitted to the emergency department in our hospital from March 2018 to October 2019 were selected as the research objects. According to the screening criteria， the patients were divided into cardiogenic chest pain group（n=88） and non-cardiogenic chest pain group （n=69）， and the healthy group was used as the control group （n=46）， all the subjects were tested for cTnT， NT-proBNP and D-D， and at the same time the change trend of cTnT， NT-proBNP and D-D after the patient admitted to hospital was folloued up and then the prognosis of the patients was evaluated. Results The levels of cTnT， NT-proBNP and D-D in the two patient groups were higher than those in the healthy group， the differences were statistically significant（P<）. The levels of cTnT and NT-proBNP in the cardiogenic chest pa