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[1]祖素云,杨贵荣,马增春,等.前白蛋白对急性心肌梗死的早期预警价值[J].医学研究与战创伤救治(原医学研究生学报),2016,18(01):13-16.[doi:10.3969/j.issn.1672-271X.2016.01.004]
　ZU Su-yun,YANG Gui-rong,MA Zeng-chun,et al.The value of prealbumin in the early diagnosis of acute myocardical infarction[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2016,18(01):13-16.[doi:10.3969/j.issn.1672-271X.2016.01.004]
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前白蛋白对急性心肌梗死的早期预警价值()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第18卷
期数:
2016年01期
页码:
13-16
栏目:
出版日期:
2016-01-20

文章信息/Info

Title:
The value of prealbumin in the early diagnosis of acute myocardical infarction
作者:
祖素云1; 杨贵荣2; 马增春3; 高 敏2; 赵海滨2; 王 丹2; 杨长春2
1. 066300 河北抚宁,抚宁县人民医院内三科;
2.100039 北京，武警总医院；
3. 100850 北京，军事医学科学院放射医学研究所
Author(s):
ZU Su-yun1;  YANG Gui-rong2;  MA Zeng-chun3;  GAO Min2;  ZHAO Hai-bin2;  WANG Dan2;  YANG Chang-chun2.
1. Department of Internal Medicine, Funing Country People s Hospital, Funing, Hebei 066300, China;
2. the General Hospital of Chinese Peoples Armed Police Forces, Beijing 100039, China;
3. Institute of Radiation Medicine, Academy of Military Medical Sciences, Beijing 100850, China
关键词:
急性心肌梗死; 前白蛋白; 预警; 诊断
Keywords:
acute myocardial infarction;  prealbumin;  warning;  diagnosis
分类号:
R542.22
DOI:
10.3969/j.issn.1672-271X.2016.01.004
文献标志码:
A
摘要:
目的 探讨前白蛋白对12 h内就诊的缺血性胸痛患者急性心肌梗死（acute myocardial infarction,AMI）的早期预警价值。方法 选取以胸痛为主诉的12 h内发病 的疑诊急性心肌梗死180例为研究对象，其中确诊AMI 103例。根据发病时间不同，将AMI患者分为0～3 h、4～6 h和7～12 h组，检测其前白蛋白、高敏肌钙蛋白T（hs-cTnT）、肌 酸激酶同工酶（CK-MB）水平，比较前白蛋白及肌钙蛋白T、肌酸激酶同工酶诊断AMI的敏感性、特异性、阳性预测值、阴性预测值。结果 发病0～3 h，前白蛋白诊断AMI的敏感性 为23.70%[95%可信区间（CI）:17.00％～31.94%]、特异性73.33%(95%CI: 57.79％～84.90%)、阳性预测值0.89、阴性预测值1.04；随发病时间延长，前白蛋白诊断AMI的敏感性增 加，发病7～12 h PA诊断敏感性、特异性分别为53.33%(95%CI:44.58％～61.90%)、57.78%(95%CI:42.24％～72.01%)，同期hs-cTnT及CK-MB诊断AMI的敏感性、特异性分别为 95.56%(95%CI:90.16％～98.18%)、80%(95%CI:64.95％～89.91%)、78.52%(95%CI:70.45％～84.92%)、73.33%(95%CI:57.79％～84.90%)，与hs-cTnT及CK-MB相比，发病7～12 h前 白蛋白诊断AMI的准确性低于hs-cTnT及CK-MB。结论 前白蛋白在早期对急性心肌梗死具有一定预警价值，但诊断急性心肌梗死敏感性、特异性较低。
Abstract:
Objective To investigate the accuracy of prealbumin in warning acute myocardial infarction(AMI) in patients with chest pain of presumed ischemic origin in 12 hours admitted to hospital. Methods 180 patients with ischemic chest pain who suspected to acute myocardial infarction admitted to emergency department of the general hospital of Chinese people’s armed police forces in 12 hours from April 2013 to April 2014 were enrolled in this study. According to the onset time, 103 patients diagnosed AMI were divided into group 0-3 h, group 4-6 h and group 7-12 h. Serum prealbumin, high sensitive troponin T(hs-cTnT) and creatine kinase myocardial band(CK-MB) at admission were detected. At the same time, sensitivity, specificity, positive predictive value and negative predictive value of prealbumin, hs-cTnT and CK-MB for acute myocardial infarction were compared respectively. Results 0-3 h at onset, prealbumin testing to identify myocardial infarction in patients with chest pain of presumed ischemic origin had a sensitivity of 23.70% [95% confidence interval（CI） 17.00%-31.94%] and a specificity of 73.33%(95%CI 57.79%-84.90%), a positive predictive value of 0.89 and a negative predictive value of 1.04. With the development of disease, prealbumin dignostic sensitivity increased, while specificity had no change. 7-12 h after admission, prealbumin had a sensitivity of 53.33%(44.58%-61.90%) and a specificity of 57.78%(42.24%-72.01%). The sensitivity and specificity of corresponding hs-cTnT and CK-MB was 95.56%(90.16%-98.18%), 80%(64.95%-89.91%), 78.52%(70.45%-84.92%), 73.33%(57.79%-84.90%) respectively, thus diagnostic accuracy of prealbumin at 7-12 h was lower than that of hs-cTnT and CK-MB. Conclusion Prealbumin is a certain value to AMI diagnosis at early stage, but specificity and sensitivity is lower.

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备注/Memo

备注/Memo:
国家自然科学基金资助项目（81274127）
更新日期/Last Update: 2016-01-20