ROC曲线评价RDW、MPV和cTnI在急性冠脉综合征早期诊断中的应用。

目的观察红细胞体积分布宽度（RDW）、平均血小板体积（MPV）和肌钙蛋白I（cTnI）在急性冠脉综合征（ACS）患者中的变化，运用ROC曲线分析它们在ACS早期诊断中的价值。方法收集ACS患者191例（ACS组）和具有胸痛等相似症状的非ACS患者206例（非ACS组），于入院6h内分别检测心电图、cTnI、血常规、肌酐和血脂等，并观察RDW、MPV和cTnI的ROC曲线特征。结果ACS组RBC、Hb、PLT、CREA和LDL-C的测定值分别为（3.82±0．57）X10^12／L、（101．3±3．3）g/L、195（98．6-334．8）×10^12／L、69（45-120）μmol／L、（2．95±0．85）mg/dl；非ACS组分别为（3．89±0．50）×10“／L、（103．5±3．7）g／L、201（135．2-346．9）×10’／L、71（49-100）μmol／L、（2．82±O．75）mg／dL，两组比较差异无统计学意义（P〉0．05）。ACS组RDW、MPV和cTnI的测定值分别为13．70（12．00-15．20）％、9．4（7．42-12．31）fL、（5．63±1．39）μg／L；非ACS组RDW、MPV和cTnI的测定值分别为12．60（11．20-13．83）％、8．2（6．24-10．97）f1J、（0．04±0．01）μg／L，其差异有统计学意义（P〈0．01）。ACS组RDW、MPV和cTnI的ROC曲线下面积（AUC）分别为73．5％、78．8％和98．1％；其诊断界值分别为13．15％、12．45fL和0．06μg/L。结论RDW和MPV可以与cTnI及其他心脏标志物联合检测作为ACS早期诊断指标。

Evaluation of red blood cell distribution width, mean platelet volume and cardiac troponin I for early diagnosis of acute coronary syndromes by using ROC curve

Objective To observe the changes of red blood cell distribution width, mean platelet volume and cardiac troponin I in patients with Acute Coronary Syndromes, and to evaluate the value for early diagnosis by using ROC curve. Methods 191 patients with ACS and 206 patients with the chest pain syndromes non-ACS were selected in this study. Electrocardiogram,blood routine,creatinine, LDL-C and cardiac troponin I were determined within six hours after hospitalized,meanwhile the feature of ROC curves was observed. Results There was no significant difference between ACS group and non-ACS group about red blood cell, hemoglobin, platelet,creatinine and LDL-C［(3.82±0.57)×1012/L,(101.3±3.3)g/L,195（98.6-334.8）×109/L,69（45-120）μmol/L,(2.95±0.85)mg/dl vs (3.89±0.50）×1012/L,(103.5±3.7)g/L,201（135.2-346.9）×109/L,71（49-100）μmol/L,(2.82±0.75)mg/dL］ (P＞ 0. 05). Red blood cell distribution width, mean platelet volume and the cardiac troponin I in ACS group［13.70(12.00-15.20)%,9.4（7.42-12.31）fL,(5.63±1.39)μg/L］ were significantly higher than that of non-ACS group［12.60（11.20-13.83）%,8.2（6.24-10.97）fL,(0.04.±0.01)μg/L］ (P＜0.01) .The area under ROC curves of red blood cell distribution width,mean platelet volume and cardiac troponin I were 73.5%, 78.8%, 98.1% respectively, while the best cut-off value was 13.15%, 12.45 fL, 0.06 μg/L respectively. Conclusions The combination using of red blood cell distribution width andmean platelet volume and cardiac troponin I and other conventional cardiac markers might be served as early diagnosis marker for the ACS patients admitted to emergency departments.