Value of Neurotrophin-3 in early diagnosis of acute myocardial infarction
-
摘要:
目的 研究神经源性营养因子3（NT-3）对早期急性心肌梗死（AMI）的诊断价值和意义。 方法 选取胸痛疑似心肌梗死患者90例，其中确诊AMI患者组45例为观察组，胸痛但检查不是AMI者45例为对照组，分别检测两组患者在胸痛发病<3 h、3~6 h及6~12 h的血清NT3、CK-MB和cTnT水平；比较在AMI发病<3 h、3~6 h及6~12 h时NT-3、CK-MB和cTnT诊断AMI时的敏感性及特异性。 结果 对照组血清NT-3、CK-MB和cTnT没有明显变化（P>0.05）。在AMI组患者中，血清NT-3在AMI后<3 h即显著升高（P<0.01），在3~6 h及6~12 h升高更为明显（P<0.01）；血清CK-MB在AMI发病6 h内无明显升高（P>0.05），在6~12 h时才升高（P<0.01）；血清cTnT在AMI<3 h无明显增加（P>0.05），3~6 h和6~12 h显著升高（P<0.01）。在AMI发病<3 h、3~6 h时，血清NT-3的敏感性及特异性高于CK-MB、cTnT，血清NT-3在AMI发生6~12 h的敏感性及特异性与cTnT相近，且NT-3和cTnT的敏感性和特异性均高于CK-MB。 结论 血清NT-3在AMI早期诊断中敏感性和特异性可能优于传统心肌标记物，可以作为一种新的AMI的早期诊断指标。 Abstract:Objective To explore the value of the biochemical marker Neurotrophin-3 (NT-3) in early diagnosis of acute myocardial infarction (AMI). Methods A total of 90 chest pain patients with suspected myocardial infarction were selected. 45 patients with confirmed AMI were selected as the observation group, and 45 cases of chest pain but not AMI were selected as the control group. Serum NT-3, CK-MB and cTnT levels were measured in the two groups at <3 h, 3-6 h and 6-12 h after chest pain. The sensitivity and specificity of NT-3, CK-MB and cTnT in the diagnosis of AMI were compared with <3 h, 3-6 h and 6-12 h after AMI. Results There were no significant changes in serum NT-3, CK-MB and cTnT in the control group (P>0.05). Serum NT-3 in patients with AMI was significantly increased at <3 h after AMI (P<0.01), and increased significantly at 3-6 h and 6-12 h (P<0.01). Serum CK-MB in patients with AMI did not increase significantly within 6 h after AMI (P>0.05), but increased at 6-12 h (P<0.01).Serum cTnT did not increase significantly at<3 h after AMI (P>0.05), and increased significantly at 3-6 h and 6-12 h after AMI (P<0.01). The sensitivity and specificity of serum NT-3 were higher than CK-MB and cTnT at <3 h and 3-6 h after AMI.The sensitivity and specificity of serum NT-3 at 6-12 h after AMI were similar to those of cTnT, and the sensitivity and specificity of NT-3 and cTnT were higher than those of CK-MB. Conclusion The sensitivity and specificity of serum NT-3 in early diagnosis of AMI may be superior to traditional myocardial markers. It can be used as a new early diagnostic indicator of AMI. -
表 1 两组患者不同发病时间血清各因子测定值比较（n=45，Mean±SD）
分组 检测时间 NT-3（pg/mL） CK-MB（U/L） cTnT（ng/mL） 对照组 <3 h 132.47±92.42 24.27±3.96 0.018±0.011 3~6 h 139.76±60.38 24.62±5.18 0.018±0.009 6~12 h 120.18±9.85 23.42±4.73 0.021±0.018 观察组 <3 h 360.17±175.48* 25.51±3.86 0.024±0.015 3~6 h 472.58±204.99*# 26.62±4.76 0.136±0.089*# 6~12 h 498.31±218.95*# 59.24±23.96*#+ 4.052±2.546*#+ *P<0.01, 观察组vs对照组；#P<0.01, 观察组vs <3 h；+ P<0.01vs 3~6 h. 
下载: 导出CSV
表 2 NT-3、CK-MB和cTnT在AMI发病不同时间段诊断的敏感性和特异性（n=45，Mean±SD）
检测时间 分组 敏感性（%） 特异性（%） <3 h NT-3 86.7 88.9 CK-MB 48.9 51.1 cTnT 51.1 68.9 3−6 h NT-3 93.3 91.1 CK-MB 60.0 62.2 cTnT 88.9 88.9 6−12 h NT-3 95.6 91.1 CK-MB 75.6 77.8 cTnT 95.6 93.3
下载: 导出CSV
-
[1] 张秋云. 24 h心电图监测对急性心肌梗死超急性期的诊断效果观察[J]. 实用医学影像杂志, 2018, 42(06): 537-8 [2] 勾朝阳. 多指标联合检测在急性心肌梗死早期诊断的应用评价[J]. 社区医学杂志, 2013, 11(18): 48-9 [3] 张雅春. 分析急性心肌梗死病人心肌酶谱的动态变化及其临床意义[J]. 世界最新医学信息文摘, 2017, 17(93): 148-52 [4] 罗俭权, 陶珊花, 李竞春, 等. 新型心肌损伤标志物与传统心肌酶对诊断早期急性心肌梗死的敏感度和特异度评价[J]. 国际检验医学杂志, 2017, 38(3): 417-8 [5] 王喜栋, 赵 捷, 张晋霞, 等. 心肌酶谱与心肌损伤标志物在急性心肌梗死诊断中的价值[J]. 河北医科大学学报, 2011, 32(8): 913-5 [6] Li X, Sun DC, Li Y, et al. Neurotrophin-3 improves fracture healing in rats[J]. Eur Rev Med Pharmacol Sci, 2018, 22(8): 2439-46 [7] Katoh-Semba R, Kaisho Y, Shintani A, et al. Tissue distribution and immunocytochemical localization of neurotrophin-3 in the brain and peripheral tissues of rats[J]. J Neurochem, 1996, 66(1): 330-7 [8] Rana OR, Schauerte P, Hommes D, et al. Mechanical stretch induces nerve sprouting in rat sympathetic neurocytes[J]. Autonomic Neuroscien, 2010, 155(1/2): 25-32 [9] Ernst AF, Gallo G, Letourneau PC, et al. Stabilization of growing retinal axons by the combined signaling of nitric oxide and Brain-Derived neurotrophic factor[J]. J Neuroscien, 2000, 20(4): 1458-69 [10] 梁 峰, 胡大一, 方 全, 等. 心肌梗死定义的全球统一和更新完善[J]. 中国循证心血管医学杂志, 2018, 10(09): 1025-30 [11] 常玉梅. 实验室对急性心肌梗死早期诊断指标的应用及评价[J]. 实用医技杂志, 2008, 15(17): 2208-9 [12] 邵小燕. 探讨心肌酶谱与肌钙蛋白I(cTnI)联合检测在急性心肌梗死早期诊断中的应用[J]. 世界最新医学信息文摘, 2018, 18(94): 129-39 [13] 王道秀. 心肌肌钙蛋白T,肌钙蛋白Ⅰ及CK-MB在急性心肌梗死的临床诊断中的应用[J]. 现代诊断与治疗, 2018, 29(19): 3098-100 [14] Scarisbrick IA, Jones EG, Isackson PJ. Coexpression of mRNAs for NGF, BDNF, and NT-3 in the cardiovascular system of the pre-and postnatal rat[J]. J Neuroscien, 1993, 13(3): 875-93 [15] Altar CA, Criden MR, Lindsay RM, et al. Characterization and topography of high-affinity 125I-neurotrophin-3 binding to mammalian brain[J]. J Neuroscien, 1993, 13(2): 733-43 [16] 郑 蕾, 王艺明. 帕罗西汀治疗抑郁症后血清神经营养因子3的变化[J]. 贵阳医学院学报, 2013, 38(4): 347-50 [17] Caras I, Francisca I, Grigorescu A, et al. Neurotrophin-3,TNF-alpha and IL-6 relations in serum and cerebrospinal fluid of ischemic stroke patients[J]. Roum Arch Microbiol Immunol, 2005, 64(14): 27-33 [18] 曾洪艳, 李力燕, 郭小兵, 等. 神经营养因子、凋亡相关因子和轴突导向因子在大鼠神经管畸形发育中的表达[J]. 昆明医科大学学报, 2012, 33(11): 13-8 [19] 游 勇, 何秀群. hs-cTnT在老年急性胸痛患者AMI诊断中的阈值及性能研究[J]. 深圳中西医结合杂志, 2016, 26(22): 38-40 [20] Bernd P, Miles K, Rozenberg I, et al. Neurotrophin-3 and TrkC are expressed in the outflow tract of the developing chicken heart[J]. Developmental Dynamics, 2004, 230(4): 767-72 [21] Cristofaro B, Stone OA, Caporali A, et al. Neurotrophin-3 is a novel angiogenic factor capable of therapeutic neovascularization in a mouse model of limb ischemia[J]. Arterioscler Thromb Vasc Biol, 2010, 30(6): 1143-50 [22] Aridgides D, Salvador R, Pereiraperrin M. Trypanosoma cruzi highjacks TrkC to enter cardiomyocytes and cardiac fibroblasts while exploiting TrkA for cardioprotection against oxidative stress[J]. Cell Microbiol, 2013, 15(8): 1357-66 [23] Kaisho Y, Shintani A, Nishida M, et al. Developmental changes of neurotrophin-3 level in the mouse brain detected by a highly sensitive enzyme immunoassay[J]. Brain Res, 1994, 666(1): 143-6 [24] 李志进, 孙沫逸, 王 磊, 等. NT-3对腺样囊性癌细胞系ACC-M体外粘附能力的影响[J]. 现代肿瘤医学, 2006, 25(6): 657-9 -
点击查看大图
表(2)
计量
- 文章访问数: 500
- HTML全文浏览量: 298
- PDF下载量: 8
- 被引次数: 0
