目的 探讨数字减影血管造影(DSA)在冠状动脉病变诊断中的应用价值,并评估血清学参数相对于DSA金标准的诊断效能。方法 本研究纳入100名确诊为冠心病的患者。病例组为100例DSA确诊的冠心病患者,对照组按1:1比例匹配100例同期接受DSA检查排除冠心病的患者。应用DSA技术分别评估冠心病的狭窄程度及部位等指征。回顾性收集并对比分析两组患者的各项血清学参数(cTnI、CK-MB、hs-CRP、LDL-C、TC),计算血清学指标诊断冠心病的效能,并进一步探究以上评估于入组患者性别亚组间的统计学差异。结果 病例组与对照组在性别、年龄、BMI等基线资料上均衡可比(P > 0.05)。以DSA为金标准,cTnI诊断冠心病的灵敏度为82.0%,特异度为85.0%;hs-CRP的灵敏度为85.0%,特异度为75.0%。 cTnI、hs-CRP水平随冠状动脉狭窄程度加重而显著升高(P < 0.05)。且以上冠心病评价指征于患者性别亚组间均无统计学差异( P <0.05)。结论 DSA技术可用于冠状动脉病变发生的部位、形态、数目等指征的明确评估,且于不同性别亚组间无统计学差异。血清学参数,尤其是cTnI和hs-CRP,对冠心病具有良好的辅助诊断价值,其水平与病变严重程度相关,可作为DSA检查前的有效筛查工具,为后续的治疗提供重要的参考依据。
Objective: To investigate the clinical value of digital subtraction angiography (DSA) in the diagnosis of coronary artery disease (CAD) and to evaluate the diagnostic performance of serological parameters relative to the DSA gold standard. Methods: A total of 100 patients with confirmed CAD were included in this study. The case group comprised 100 patients with CAD confirmed by DSA, while the control group consisted of 100 age- and sex-matched individuals who underwent DSA during the same period and were excluded from CAD. DSA was employed to assess the degree and location of coronary artery stenosis. Retrospective collection and comparative analysis of serological parameters (cTnI, CK-MB, hs-CRP, LDL-C, TC) were performed between the two groups. The diagnostic efficacy of these serological indicators for CAD was calculated, and subgroup analyses were conducted to explore potential sex-related differences. Results: The case and control groups were comparable in baseline characteristics such as sex, age, and BMI (P > 0.05). Using DSA as the gold standard, the sensitivity and specificity of cTnI for diagnosing CAD were 82.0% and 85.0%, respectively; hs-CRP demonstrated a sensitivity of 85.0% and specificity of 75.0%. Levels of cTnI and hs-CRP increased significantly with the severity of coronary stenosis (P < 0.05). No statistically significant differences were observed between male and female subgroups (P > 0.05). Conclusion: DSA provides definitive assessment of lesion location, morphology, and number in coronary artery disease, with no significant sex-related differences. Serological markers, particularly cTnI and hs-CRP, demonstrate good auxiliary diagnostic value for CAD. Their levels correlate with disease severity and may serve as effective screening tools prior to DSA, offering important reference value for subsequent clinical management.
论著
目的 探讨急性心衰(AHF)患者NTpro-BNP,cTnI,hs-CRP的变化及其临床意义。方法 分别选取342例AHF患者和30例同期健康查体者作为观察组和对照组。统计2组NTpro-BNP,cTnI,hs-CRP及LVEF水平及随访期间死亡率。分析患者NTpro-BNP,cTnI,hs-CRP与其LVEF的关系及其联合预测患者死亡率的价值。结果 观察组NTpro-BNP,cTnI,hs-CRP均较对照组升高,LVEF则较对照组降低;与T0比较,患者T2、T3、T4的NTpro-BNP,cTnI,hs-CRP均降低,LVEF则升高;心衰较严重患者其NTpro-BNP,cTnI,hs-CRP较高,LVEF则较低(P<0.05)。观察组存活患者NTpro-BNP,cTnI,hs-CRP较低,LVEF则较高(P<0.05)。AHF患者NTpro-BNP,cTnI,hs-CRP与其LVEF均呈负相关且预测预后的价值良好。结论 AHF患者NTpro-BNP,cTnI,hs-CRP与其心功能相关且其联合预测预后的价值较高,可能作为AHF患者心功能及患者预后评估的参考指标。
Objective To study the NTpro-BNP, cTnI and hs-CRP changes of patients with acute heart failure(AHF)and its clinical significance. Methods 342 patients with AHF and 30 healthy persons were selected as observation group and control group. NTpro-BNP, cTnI, hs-CRP and LVEF level of two groups and mortality during the follow-up period were analyzed. Relationship between NTpro-BNP, cTnI, hs-CRP and LVEF, and value of them unitedly predicting mortality of patients were analyzed. Results NTpro-BNP, cTnI, hs-CRP of observation group were higher than that of the control group while LVEF was lower than that of the control group; Compared with T0, NTpro-BNP, cTnI, hs-CRP of observation group in T2, T3, T4 were reduced while LVEF increased; Patients with more serious heart failure had higher NTpro-BNP, cTnI, hs-CRP and lower LVEF (P<0.05). NTpro-BNP, cTnI, hs- CRP of survived patients in observation group were lower while LVEF was higher(P<0.05). NTpro-BNP,cTnI and hs-CRP of AHF patients were negative correlated with LVEF and value of them predicting good prognosis. Conclusion NTpro-BNP, cTnI, hs-CRP of AHF patients are related to its heart function and the value of them unitedly predicting prognosis is good, thus they may used cardiac function and prognosis evaluation reference index of AHF patient.