文章摘要
秦嵩博,由辰飞,张伟佳,冯天策,张保跃,李青,李庆臣.血清sST2在主动脉壁间血肿和主动脉夹层诊断中的价值[J].济宁医学院学报,2022,45(6):410-413
血清sST2在主动脉壁间血肿和主动脉夹层诊断中的价值
Analysis of serum sST2 in the diagnosis of aortic intermural hematoma and aortic dissection
投稿时间:2022-03-03  
DOI:10.3969/j.issn.1000-9760.2022.06.006
中文关键词: 主动脉夹层;主动脉壁间血肿;可溶性ST2;D-二聚体;诊断
英文关键词: Aortic dissection;Aortic intermural hematoma;sST2;D-dimer;Diagnosis
基金项目:济宁医学院教师科研扶持基金(科技类)(JYFC2019FKJ204);济宁医学院大学生创新创业训练计划(CX2020129)
作者单位E-mail
秦嵩博 济宁医学院口腔医学院, 济宁 272013  
由辰飞 济宁医学院口腔医学院, 济宁 272013  
张伟佳 济宁医学院口腔医学院, 济宁 272013  
冯天策 济宁医学院口腔医学院, 济宁 272013  
张保跃 济宁医学院口腔医学院, 济宁 272013  
李青 济宁医学院口腔医学院, 济宁 272013 378316439@qq.com 
李庆臣 济宁医学院附属医院, 济宁 272029 surgeonxw@163.com 
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中文摘要:
      目的 观察血清sST2在主动脉壁间血肿、主动脉夹层(Stanford B型)患者中的表达,分析sST2浓度与主动脉壁间血肿和夹层的关系,探讨其在该疾病诊断中的应用价值。方法 收集济宁医学院附属医院和南京市第一医院的92例患者,其中主动脉夹层40例,主动脉壁间血肿52例。收集患者入院24h内的血清sST2水平,并统计其同期的D-二聚体浓度等临床数据,比较主动脉夹层与主动脉壁间血肿患者sST2、D-二聚体水平,并采用ROC曲线分别比较sST2和D-二聚体以及两者联合对于主动脉夹层和主动脉壁间血肿的诊断意义。结果 sST2在主动脉夹层患者中表达量明显高于在主动脉壁间血肿患者,差异有统计学意义(Z=-4.73,P<0.001);对主动脉夹层诊断得到sST2的曲线下最大面积为0.788,最佳界值为27.84ng/mL,D-二聚体的曲线下最大面积为0.618,最佳界值为1.215mg/L,两者联合诊断曲线下面积为0.216;对主动脉壁间血肿诊断得到sST2、D-二聚体的曲线下面积分别为0.212、0.382,两项联合检测曲线下面积0.784,最佳界值敏感度0.692,特异性为0.80。结论 sST2在主动脉夹层患者中的表达明显高于在主动脉壁间血肿患者;sST2对主动脉夹层有一定诊断价值,且强于D-二聚体;两者联合对主动脉壁间血肿有一定的诊断价值。
英文摘要:
      Objective To observe the expression of serum sST2 in patients with aortic intermural hematoma and aortic dissection(Stanford B type),to analyze the relationship between sST2 concentration and aortic intermural hematoma and dissection,and to explore its application value in the diagnosis of these disease.Methods 92 patients were collected from the Affiliated Hospital of Jining Medical University and The First Hospital of Nanjing,including 40 cases of aortic dissection and 52 cases of aortic intermural hematoma.Venous blood of patients were collected within 24 hours after admission,the level of sST2 in their serum detected with Elisa method,and the clinical data such as D-dimer concentration in the same period counted.The levels of sST2 and D-dimer in patients with aortic dissection and aortic intramural hematoma were compared.ROC curve was used to compare the significance of sST2 and D-dimer and their combination in the diagnosis of aortic dissection and aortic intramural hematoma.Results The expression of sST2 in patients with aortic dissection was significantly higher than that in patients with intermural aortic hematoma,and the difference was statistically significant(Z=-4.73,P<0.001);the maximum area under the curve of sST2 in the diagnosis of aortic dissection was 0.788,and the best cutoff value was 27.84ng/mL.The maximum area under the curve of D-dimer was 0.618,and the best cutoff value was 1.215mg/L,and the maximum area under the curve of combined diagnosis was 0.216.For the diagnosis of aortic intermural hematoma,the maximum areas under the curve of sST2 and D-dimer were 0.212 and 0.382 respectively,the maximum area under the curve of the two combined detection were 0.784,the best cut-off value was 0.692,and the specificity was 0.80.RConclusion The expression of sST2 in patients with aortic dissection is significantly higher than that in patients with aortic intramural hematoma.sST2 has a certain diagnostic value in aortic dissection and its value is stronger than that in D-dimer.Both of them have no diagnostic significance in aortic intramural hematoma,but the combination of the two has certain diagnostic value in aortic intermural hematoma.
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