目的:探究心肌损伤标志物阳性患者中心肌标志物、白细胞(WBC)计数及血小板分布宽度(PDW)联合检测的诊断价值。方法:选取2017年1月～2018年1月我院收治的100例心肌损伤标志物阳性患者作为观察组,另选取100例健康体检者作为对照组。检测两组对象入院时的血清心肌标志物肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌红蛋白(MYO)以及WBC计数、PDW水平,并分析这些指标单项检测和联合检测对急性心肌梗死(AMI)早期诊断的价值。结果:血清cTnI、CK-MB、MYO、WBC计数及PDW水平比较,观察组均高于对照组,组间比较差异具有统计学意义(P<0.05)。100例心肌损伤标志物阳性患者中有48例(48.00%)经最终临床诊断确诊为AMI。与对照组比较,观察组血清各项指标单独检测及5项指标联合检测的阳性率均显著提高(P<0.05)。5项指标联合检测诊断AMI的敏感度、特异性分别为95.83%、94.23%,均高于各项指标的单独检测,比较差异具有统计学意义(P<0.05)。结论:血清cTnI、CK-MB、MYO、WBC计数及PDW这5项指标的联合检测有助于AMI的早期诊断,可提高诊断的敏感度和特异性。

Objective:To explore the diagnostic value of combined detection of myocardial markers, white blood cell (WBC) counts and platelet distribution width (PDW) in patients with markers of myocardial injury. Methods:One hundred patients with markers of myocardial injury treated in our hospital from January 2017 to January 2018 were selected as the observation group. Another 100 healthy persons were selected as the control group. Serum levels of serum cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), myoglobin (MYO), WBC count, and PDW were measured at the time of admission. And individual and combined detections of these indexes in early diagnosis of acute myocardial infarction (AMI) were analysed. Results: The serum cTnI, CK-MB, MYO, WBC counts and PDW levels of the observation group were significantly higher than those of the control group, and the difference between the groups was statistically significant (P<0.05). Of the 100 patients with positive markers of myocardial injury, 48 (48.00%) were diagnosed with AMI by final clinical diagnosis. Compared with the control group, the positive rate of the serum sera and the combined detection of the five indicators were significantly increased in the observation group (P<0.05). The sensitivity and specificity of the combined detection of five indexes for the diagnosis of AMI were 95.83% and 94.23%, respectively, which were higher than those of the individual indicators; the difference was statistically significant (P<0.05). Conclusion: Combined detection of serum cTnI, CK-MB, MYO, WBC counts, and PDW may be helpful for the early diagnosis of AMI and may improve the sensitivity and specificity of diagnosis.

R542.22; R446.1

苏州市卫生科技项目(GWZX201604)