探索d-dimer与troponin比率在区分急性肺栓塞和非ST升高心肌梗塞之间发挥的作用
Mostafa Afifi1, Yousra Nasr2, Mohamed Elayady3
1Faculty of Medicine, Al-Azhar University, Cairo, EGY.
Cureus
|September 15, 2025
概括
D-二聚体与热素的比率有效地区分了急性肺栓塞 (APE) 和非ST升高心肌梗塞 (NSTEMI). 这种生物标志物提供了一个简单,具有成本效益的工具,以改善这些心血管紧急情况的早期诊断.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 诊断工具 诊断工具 诊断工具
背景情况:
- 急性肺栓塞 (APE) 和非ST升高心肌梗塞 (NSTEMI) 是常见的心血管紧急情况,症状重叠.
- 在这两种情况中,D-二聚合物和 I 热波宁水平的升高降低了它们作为单一诊断标记物的特异性.
- 在APE和NSTEMI中,由于类似的临床表现和初步实验室发现,出现了诊断挑战.
研究的目的:
- 评估D-二聚体与热素的比率,作为区分APE和NSTEMI的潜在生物标志物.
- 探索该比率在临床实践中的诊断实用性.
主要方法:
- 一项涉及40名被诊断患有APE或NSTEMI的患者的观测横截面研究.
- 收集人口统计数据和实验室值,包括D-二次素,I型热素,以及计算的D-二次素与热素的比率.
- 使用t测试和皮尔森相关系数进行统计分析,以比较组和评估关系.
主要成果:
- 与NSTEMI患者 (0.36±0.49;p<0.001) 相比,患有APE的患者表现出显著更高的D-二聚体与热素比率 (42.1±34.7).
- 热素I与APE中的比率呈负相关性 (r=-0.590;p<0.001).
- D-二元体与NSTEMI中的比率有显著的正相关性 (r=0.798;p<0.001).
结论:
- D-二聚体与热素的比率作为APE和NSTEMI之间的有效区分器,反映了不同的病理生理过程.
- 这个比率为临床医生提供了一个简单,廉价的补充,以提高早期诊断的准确性.
- 利用这种比率可以帮助指导适合和及时治疗心血管紧急情况的治疗策略.
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