摘要
目的 分析肌酸激酶同工酶(CK-MB)、纤维蛋白原/白蛋白比值(FAR)、D-二聚体联合检测对老年急性心肌梗死(AMI)患者的临床应用价值.方法 分析2022年1月至2023年1月阜南县人民医院收治的92例老年AMI患者(AMI组)的临床资料,选取同期因胸痛胸闷入院的41例老年非AMI患者(依据冠状动脉造影结果证实)为对照组,对两组间左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、CK-MB、FAR、D-二聚体水平进行比较;并对比AMI不同病情严重程度患者的CK-MB、FAR、D-二聚体;分析老年AMI患者CK-MB、FAR、D-二聚体与LVEDD、LVEF的相关性,并评估CK-MB、FAR、D-二聚体对AMI诊断的应用价值.结果 AMI组患者LVEDD、CK-MB、FAR、D-二聚体水平均高于对照组,而LVEF水平均低于对照组,差异均有统计学意义(t=5.987、6.697、8.080、7.792、3.116,P<0.05);CK-MB、FAR、D-二聚体水平在AMI组不同病情严重程度患者中的比较均为:重度狭窄组>中度狭窄组>轻度狭窄组,差异有统计学意义(F=10.228、14.483、8.573,P<0.05);Pearson相关性分析显示,CK-MB、FAR、D-二聚体与LVEDD呈正相关(r=0.562、0.557、0.394,P<0.05),与LVEF呈负相关(r=-0.146、-0.385、-0.137,P<0.05);ROC曲线显示,CK-MB、FAR、D-二聚体及其联合检测诊断AMI的AUC分别为0.839、0.874、0.861及0.958.结论 CK-MB、FAR、D-二聚体水平与老年AMI患者心功能及病情有关,通过联合检测对诊断AMI发生预测效能较好.
Abstract
Objective To analyze the clinical value of creatine kinase isoenzyme (CK-MB),fi-brinogen to albumin ratio (FAR) and D-dimer in elderly patients with acute myocardial infarction (AMI).Methods The clinical data of 92 elderly patients with AMI (AMI group) admitted to Funan County People's Hospital from January 2022 to January 2023 were retrospectively analyzed.Forty-one elderly patients with non-AMI (confirmed by coronary angiography) admitted to the hospital due to chest pain and chest tightness dur-ing the same period were selected as the control group.The levels of left ventricular end-diastolic diameter (LVEDD),left ventricular ejection fraction (LVEF),CK-MB,FAR and D-dimer were compared between the two groups.The CK-MB,FAR and D-dimer of patients with different severities of AMI were compared.The correlation between CK-MB,FAR,D-dimer and LVEDD,LVEF in elderly patients with AMI was ana-lyzed,and the application value of CK-MB,FAR and D-dimer in the diagnosis of AMI was evaluated.Results The levels of LVEDD,CK-MB,FAR and D-dimer in the AMI group were higher than those in the control group,while the level of LVEF was lower than that in the control group,the differences were statisti-cally significant (t=5.987,6.697,8.080,7.792,3.116,P<0.05).The comparison of CK-MB,FAR and D-dimer levels in patients with different severities of AMI was as follows:severe stenosis group>moderate ste-nosis group>mild stenosis group,the difference was statistically significant (F=10.228,14.483,8.573,P<0.05).Pearson correlation analysis showed that CK-MB,FAR and D-dimer were positively correlated with LVEDD (r=0.562,0.557,0.394,P<0.05),and negatively correlated with LVEF (r=-0.146,-0.385,-0.137,P<0.05).The ROC curve showed that the AUC of CK-MB,FAR,D-dimer and their combined detec-tion in the diagnosis of AMI were 0.839,0.874,0.861 and 0.958,respectively.Conclusion The levels of CK-MB,FAR,and D-dimer are related to the cardiac function and condition of elderly patients with AMI.Com-bined detection has a good predictive effect on the diagnosis of AMI.
维普
万方数据