共查询到18条相似文献,搜索用时 187 毫秒
1.
2.
3.
4.
快速检测血浆心肌脂肪酸结合蛋白诊断老年早期急性心肌梗死 总被引:1,自引:1,他引:1
目的 探讨快速检测血浆心肌脂肪酸结合蛋白(H-FABP)诊断老年早期急性心肌梗死(AMI)的价值。方法 采用免疫层析技术研制H-FABP快速检测试剂条,检测64例发病6h内的老年胸痛患者的血浆标本,比较其与心肌肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶MB同工酶(CK-MB)和肌红蛋白(MYO)诊断早期AMI的敏感性、特异性。结果 快速检测H-FABP诊断AMI的敏感性(90.48%)显著高于cTnⅠ(57.29%)和CK-MB(57.29%)(P=0.016),与MYO(85.71%)比较差异无统计学意义;H-FABP的特异性(95.35%)高于MYO(60.47%)(P=0.014),与cTnⅠ(97.44%)、CK-MB(83.72%)比较差异无统计学意义。结论 快速检测H-FABP对于早期AMI具有较高的敏感性和良好的特异性,可用于老年早期AMI的筛选。 相似文献
5.
目的:监测急性心肌梗死(AMI)患者发病后入院不同时间段心肌肌钙蛋白 I(TNI)含量,探讨其诊断急性心肌梗死的意义。方法患者入院后立即检测血液中TNI含量,利用统计软件绘制各时间段所得 TNI的受试者工作特征曲线(ROC 曲线)。结果根据ROC曲线,小于4h组,AUC为88.4%,诊断临界值为0.020,敏感性79.2%,特异性85.3%;(4-8)h组,AUC为94.3%,诊断临界值为0.025,敏感性92.5%,特异性100%;(8-12)h组,AUC为89.8%,诊断临界值为0.040,敏感性87.4%,特异性80.5%;大于12 h组,AUC为86.7%,诊断临界值为0.055,敏感性82.7%,特异性79.3%。结论针对不同时段的TNI测定值应分别选择各自时段的临界值,可提高其用于临床诊断 AMI的实用性及敏感性。 相似文献
6.
7.
8.
目的:探讨联合检测和肽素(Copeptin)、高敏心肌肌钙蛋白T( hs-cTnT)对急性心肌梗死( AMI)的早期诊断价值。方法:选取272例因胸痛4小时内就诊的患者,入院后均行冠状动脉造影术(CAG)。其中排除冠心病患者64例(CAG正常组),不稳定性心绞痛患者50例(UAP组),ST段抬高型心肌梗死(STEMI)患者82例(STEMI组),非ST段抬高型心肌梗死(NSTEMI)患者76例(NSTEMI组)。入选患者均留院观察,抽取就诊时及胸痛6小时后肘静脉血,检测和肽素、hs-cTnT水平。结果:胸痛4小时内就诊时联合检测和肽素、hs-cTnT在诊断AMI上相比单独检测hs-cTnT具有更高的灵敏度(以hs-cTnT≤14ng/L、和肽素<14pmol/L为诊断切点)。NSTEMI组:AUC为0.97[95%可信区间(CI):0.88~0.99]:AUC为0.75(95%CI:0.62~0.87),P<0.05。STEMI组:AUC为0.97(95%CI:0.88~0.99): AUC为0.74(95%CI:0.60~0.88), P<0.05。联合检测和肽素、hs-cTnT的AUC为0.912(95%CI:0.812~0.961),高于单独检测hs-cTnT(AUC为0.851,95%CI:0.713~0.936)早期诊断AMI的效能(Z=2.553,P<0.05)。结论:联合检测和肽素、hs-cTnT与单独检测hs-cTnT相比,对于早期诊断急性心肌梗死有更高的灵敏度、准确性,有助于胸痛患者早期危险分层,对治疗决策具有临床价值。 相似文献
9.
10.
王莹莹 《内科急危重症杂志》2022,28(6):492-495
摘要 目的:分析急性心肌梗死(AMI)患者室壁瘤形成的影响因素,建立预测模型。方法:收集312例AMI患者,统计室壁瘤发生情况,分为室壁瘤组(78例)与非室壁瘤组(234例),采用单、多因素方式分析AMI患者室壁瘤形成的影响因素,并建立预测模型,采用似然比卡方、Wald卡方、拟合优度检验、受试者工作特征(ROC)曲线及曲线下面积(AUC)评价模型及其预测价值。结果:312例AMI患者室壁瘤发生率为25%。Logistic回归方程显示,年龄≥60岁、吸烟史、前壁心肌梗死、前降支(LAD)近中段病变、≥4个相邻导联ST段抬高、胸痛时间≥24h为AMI患者室壁瘤形成的独立危险因素(OR=60.289、73.931、52.227、61.674、64.166、60.134,P均<0.05)。Logistic回归模型评价显示,模型建立具有统计学意义,模型构建有效,模型拟合效果较好。采用Logistic回归模型统计分析数据集,预测AMI患者室壁瘤形成的AUC为0.902,敏感度为83.33%,特异性为92.91%。结论:AMI患者室壁瘤发生率为25%,主要与吸烟史、年龄、ST段抬高、LAD近中段病变、胸痛时间、前壁心肌梗死有关,据此建立Logistic回归预测模型预测室壁瘤形成价值高。 相似文献
11.
Mengting Li Hongliang Li Canxin Zhou Xianpeng Li Jiande Gong Changxi Chen Yi Zhang 《Medicine》2021,100(39)
Growing evidence supports that the tumor microenvironment plays a key role in the development and progression of tumors. But immune microenvironment of hepatocellular carcinoma (HCC) has not yet been fully explored. In the present investigation, the clinical value and prognostic significance of immune-related genes in HCC were investigated.The immune and stromal scores of HCC were calculated through the application of Estimation of Stromal and Immune cells in Malignant Tumor tissues using Expression data Algorithm based on the Cancer Genome Atlas database. Differentially expressed genes were identified using the “edgeR” package of the R software. Functional annotation and pathway enrichment were performed using “ggplots2” and “clusterProfiler” packages in R software. Protein-protein interaction network was constructed using STRING, and the hub genes were identified through the Cytoscape. Survival analysis was performed using Kaplan-Meier methods. Tumor Immune Estimation Resource algorithm was used to view the immune landscape of the microenvironment in HCC.Firstly, the immune and stromal scores of HCC were calculated and we found that the immune and stromal scores of HCC were closely related to the patients’ prognosis. Then the differentially expressed genes were identified respectively stratified by the median value of the immune and stromal scores, and the immune-related genes that related to the prognosis in HCC patients were further identified. Functional enrichment analysis and protein-protein interaction networks further showed that these genes mainly participated in immune-related biological process. In addition, dendritic cells were found to be the most abundant in the microenvironment of HCC through Tumor Immune Estimation Resource algorithm and were significantly associated with the patients’ prognosis. To robust the results, the immune-related genes were validated in an independent dataset from the Gene Expression Omnibus database.We arrived at a more comprehensive understanding of the microenvironment of HCC and extracted 7 immune-related genes that were significantly associated with the recurrence survival of HCC. 相似文献
12.
13.
Zaoqu Liu Dechao Jiao Long Liu Xueliang Zhou Yuan Yao Zhaonan Li Jing Li Jianjian Chen Qinyu Lei Xinwei Han 《Medicine》2021,100(10)
Background:Increasing evidence has indicated immune-related genes (IRGs) play a key role in the development of hepatocellular carcinoma (HCC). Whereas, there have been no investigations proposing a reliable prognostic signature in terms of IRGs. This study aimed to develop a robust signature based on IRGs in HCC. A total of 597 HCC patients from The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) databases were enrolled in this study.Methods:The TCGA cohort was utilized for discovery, and the ICGC cohort was utilized for validation. Multiple algorithms were implemented to identify key prognostic IRGs and establish an immune-related risk signature. Bioinformatics analysis and R soft tools were utilized to annotate underlying biological functions.Results:A total of 1416 differentially expressed mRNAs (DEMs) were screened, of which 90 were differentially expressed IRGs (DEIRGs). Using univariate Cox regression analysis, we identified 33 prognostically relevant DEIRGs. Using least absolute shrinkage and selection operator (LASSO) regression and multivariate Cox regression analysis, we extracted 8 optimal DEIRGs to construct a risk signature in the TCGA cohort, and the signature was verified in the ICGC cohort. We also built a nomogram to increase the accuracy of predicting HCC prognosis. By investigating the relationship of the risk score and 8 risk genes from our signature with clinical traits, we found that the aberrant expression of the immune-related risk genes is correlated with the development of HCC. Moreover, the high-risk group was higher than the low-risk group in terms of tumor mutation burden (TMB), immune cell infiltration, and the expression of immune checkpoints (programmed cell death protein 1 [PD-1], programmed cell death ligand 1 [PD-L1], and cytotoxic T-lymphocyte-related protein 4 [CTLA-4]), and functional enrichment analysis indicated the signature enriched an intensive immune phenotype.Conclusion:This study developed a robust immune-related risk signature and built a predictive nomogram that reliably predict overall survival in HCC, which may be helpful for clinical management and personalized immunotherapy decisions. 相似文献
14.
15.
The diagnosis of biliary atresia (BA) remains a clinical challenge, reliable biomarkers that can easily distinguish BA and other forms of intrahepatic cholestasis (IC) are urgently needed.Differentially expressed genes were identified by R software. The least absolute shrinkage and selection operator regression and support vector machine algorithms were used to filter the diagnostic biomarkers of BA. The candidate biomarkers were further validated in another independent cohort of patients with BA and IC. Then CIBERSORT was used for estimating the fractions of immune cell types in BA. Gene set enrichment analyses were conducted and the correlation between diagnostic genes and immune cells was analyzed.A total of 419 differentially expressed genes in BA were detected and 2 genes (secreted phosphoprotein 1 [SPP1] and ankyrin repeat domain [ANKRD1]) among them were selected as diagnostic biomarkers. The SPP1 yielded an area under the curve (AUC) value of 0.798 (95% confidence interval [CI]: 0.742–0.854) to distinguish patients with BA from those with IC, and ANKRD1 exhibited AUC values of 0.686 (95% CI: 0.616–0.754) in discriminating BA patients and those with IC. Further integrating them into one variable resulted in a higher AUC of 0.830 (95% CI: 0.777–0.879). The regulatory T cells, M2 macrophages cells, CD4 memory T cells, and dendritic cells may be involved in the BA process. The ANKRD1 and SPP1 was negatively correlated with regulatory T cells.In conclusion, the ANKRD1 and SPP1 could potentially provide extra guidance in discriminating BA and IC. The immune cell infiltration of BA gives us new insight to explore its pathogenesis. 相似文献
16.
17.
目的 探讨基于多层螺旋CT(MSCT)检测心外膜脂肪(EAT)联合左心耳射血分数(LAAEF)预测冠心病患者并发房颤的效能。方法 选取2019年4月~2020年12月我院收治的189例冠心病患者,根据6个月内是否发生房颤分为两组:房颤组(n=47)和无房颤组(n=142),比较两组基线资料、EAT体积、LAAEF,采用多因素Logistic回归方程分析冠心病并发房颤的相关影响因素,采用受试者工作特征(ROC)曲线及ROC下面积(AUC)分析EAT体积、LAAEF及联合预测房颤的价值。结果 房颤组患者的高血压、Gensini评分、冠心病类型与无房颤组比较,差异有统计学意义(P<0.05或P<0.01);房颤组患者的EAT体积高于无房颤组,LAAEF低于无房颤组(均P<0.01);将高血压、Gensini评分、冠心病类型控制后,EAT体积、LAAEF仍是发生房颤的相关影响因素(P<0.01);EAT体积预测房颤的AUC为0.726,LAAEF预测房颤的AUC为0.777,EAT体积联合LAAEF预测房颤的AUC为0.867;持续性房颤患者EAT体积高于阵发性房颤患者... 相似文献
18.