[1]胡道军a,郁 淼a,张洪磊b,等.基于Logistic回归和ROC曲线综合评价IMA,NLR,hs-CRP和CK-MB联合检测对早期急性心肌梗死的诊断价值[J].现代检验医学杂志,2016,31(05):76-80.[doi:10.3969/j.issn.1671-7414.2016.05.020]
　HU Dao-juna,YU Miaoa,ZHANG Hong-leib,et al.Comprehensive Evaluation of the Diagnostic Value of the Combined Detection of IMA,NLR,hs-CRP and CK-MB for Acute Myocardial Infarction Based on ROC Curve and Logistic Regression Analysis[J].Journal of Modern Laboratory Medicine,2016,31(05):76-80.[doi:10.3969/j.issn.1671-7414.2016.05.020]
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基于Logistic回归和ROC曲线综合评价IMA,NLR,hs-CRP和CK-MB联合检测对早期急性心肌梗死的诊断价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第31卷
期数:
2016年05期
页码:
76-80
栏目:
论著
出版日期:
2016-10-21

文章信息/Info

Title:
Comprehensive Evaluation of the Diagnostic Value of the Combined Detection of IMA,NLR,hs-CRP and CK-MB for Acute Myocardial Infarction Based on ROC Curve and Logistic Regression Analysis
文章编号:
1671-7414(2016)05-076-05
作者:
胡道军a; 郁 淼a; 张洪磊b; 汤 熠c; 张 莉a
上海交通大学医学院附属新华医院(崇明)a.检验科;
b.心血管科;
c.急诊科,上海 202150
Author(s):
HU Dao-juna; YU Miaoa; ZHANG Hong-leib; TANG Yic; ZHANG Lia
a.Department of Clinical Laboratory;
b.Department of Cardiology;
c.Department of Emergency,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine(Chongming),Shanghai 202150,China
关键词:
缺血修饰清蛋白;  中性粒细胞/淋巴细胞比率;  超敏C反应蛋白;  肌酸激酶同工酶;  肌钙蛋白;  急性心肌梗死
分类号:
R542.22; R446.112
DOI:
10.3969/j.issn.1671-7414.2016.05.020
文献标志码:
A
摘要:
目的 采用Logistic回归和受试者特征曲线(ROC)方法评价缺血修饰清蛋白(IMA)、中性粒细胞淋巴细胞比率(NLR)、超敏C反应蛋白(hs-CRP)以及肌酸激酶同工酶(CK-MB)单项及联合检测对急性心肌梗死(AMI)的早期诊断价值。方法 检测胸痛发生后3 h内和3～6 h内95例AMI患者血清IMA,hs-CRP,CK-MB和cTnI以及全血NLR水平,并与60例来自体检中心的人群(作为阴性对照)做比较。应用Logistic回归模型,绘制ROC曲线,计算曲线下面积(AUC)评价各指标的诊断价值。结果①胸痛0～3 h AMI组IMA,NLR,hs-CRP,CK-MB和cTnI的平均值分别为96.04U/L,3.77,13.39mg/L,43.26U/L和0.063 ng/ml,均高于对照组的78.10 U/L,2.02,3.12 mg/L,19.37 U/L和0.040 ng/ml,差异有统计学意义(P均<0.01)。胸痛3～6 h AMI组IMA,NLR,hs-CRP,CK-MB和cTnI指标均高于0～3 h AMI组,差异有统计学意义(P均<0.05)。②胸痛0～3 h AMI组IMA,NLR,hs-CRP和CK-MB 4项联合诊断早期AMI的ROC AUC为0.98,高于各指标单项检测的AUC(分别为0.89,0.83,0.79和0.85)。同时,4项联合检测对早期AMI诊断价值也显著高于心梗诊断的经典血清学指标cTnI(AUC=0.78)。结论 IMA,NLR,hs-CRP和CK-MB联合检测有助于提高早期AMI的诊断效能,优于各单项目检测。
Abstract:
Objective To assess the diagnostic value of IMA,NLR,hs-CRP and CK-MB individually and the combined detection for early acute myocardial infarction using ROC curve and Logistic regression.Methods To detect levels of IMA,NLR,hs-CRP,CK-MB and cTnI in serumor whole blood of AMI patients that had chest pain within 3 hours or between 3 and 6 hours,compared with 60 healthy people from Physical Examination Center.Applied Logistic regression,plotted ROC curve and calculated the area under ROC curve(AUC)to assess the diagnostic value of each index.Results The serum IMA,hs-CRP,CK-MB and cTnI or whole blood NLR levels of AMIpatients with 3 hours were remarkably higher than normal control,showing significant statistical difference(P<0.01)(AMI group:mean values of IMA,NLR,hs-CRP,CK-MB and cTnI were 96.04 U/L,3.77,13.39 mg/L,43.26 U/L and 0.063 ng/ml; normal control group:mean values of IMA,NLR,hs-CRP,CK-MB and cTnI were 78.10 U/L,2.02,3.12 mg/L,19.37 U/L and 0.040 ng/ml.The serum IMA,NLR,hs-CRP,CK-MB and cTnI levels of AMI patients in the group between 3～6hours were higher than in the group within 3 hours(P<0.05).The AUC of combined detection of IMA,NLR,hs-CRP and CK-MB for early AMI was 0.98,higherthan solo detection of IMA,NLR,hs-CRP and CK-MB,which were 0.89,0.83,0.79 and 0.85 respectively.Meanwhile,the AUC of combined detection for four markers also surpassed that of cTnI alone that was recognized as a classic serological marker to diagnose AMI(AUC=0.78).Conclusion The combined detection of IMA,NLR,hs-CRP and CK-MB is superior to a single index detection,which can significantly improve diagnostic efficiency for early AMI.

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备注/Memo

备注/Memo:
基金项目:上海市崇明县卫计委科研项目(CW2013-16)。
作者简介:胡道军(1981-),男,硕士,主管检验师,主要从事临床检验诊断学工作和研究,E-mail:996978851@qq.com。
通讯作者:张 莉,女,主任技师,E-mail:cmjy101@tom.com。
更新日期/Last Update: 2016-10-30