关键词: 尿路上皮癌抗原1, 脂蛋白(a), 急性心肌梗死, 诊断价值, 老年人

Abstract: Objective To investigate the diagnostic value of urothelial carcinoma antigen 1(UCA1) and lipoprotein (a) (Lpa) in the elderly patients with acute myocardial infarction(AMI). Methods One hundred elderly patients with AMI in our hospital from February 2018 to February 2020 were selected as the observation group, and another 100 healthy subjects receiving normal physical examination in the same period were selected as the control group. The gender, age, course of disease, body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP), smoking history, diabetes history, hyperlipidemia history, the levels of high density lipoprotein cholesterol(HDL-C), total cholesterol(TC), triglyceride(TG), homocysteine(Hcy), creatine kinase isoenzyme(CK-MB), troponin I(cTnI), UCA1, Lpa and low density lipoprotein cholesterol(LDL-C) were collected and compared. Logistic regression analysis was used to analyze the risk factors, and ROC curve was drawn to determine the diagnostic value of the risk factors. Results There were no significant differences in gender, age, course of disease, BMI, SBP and DBP between the two groups (P>0.05). The proportion of smoking, diabetes and hyperlipidemia in the observation group were significantly higher than those in the control group (P<0.05). There were no significant differences in the levels of HDL-C, TC and TG between the two groups (P>0.05). The levels of LDL-C, Hcy, LPA, CK-MB and cTnI in the observation group were significantly higher than those in the control group, while UCA1 was lower than that in the control group (P<0.05) .Logistic regression analysis showed that LPA(OR=2.316,P=0.016), UCA1(OR=3.353,P=0.034), CK-MB(OR=2.270,P=0.046), cTnI(OR=2.075,P=0.043)were the risk factors of AMI in the elderly patients. The cut-off value of LPA for diagnosing AMI was 253.55 mg/L, with a sensitivity of 0.710, with a specificity of 0.690; The cut-off value of UCA1 for diagnosing AMI was 0.11, with a sensitivity of 0.720, with a specificity of 0.700; The cut-off value of CK-MB for diagnosing AMI was 36.34 IU/L, with a sensitivity of 0.740, with a specificity of 0.710; The cut-off value of cTnI for diagnosing AMI was 2.16 ng/L, with a sensitivity of 0.740, with a specificity of 0.720 .The sensitivity, specificity of the combined diagnosis was 0.820, 0.740 respectively. Conclusions The serum levels of LPA, CK-MB, cTnI are significantly increased, and the level of UCA1 is significantly decreased in the elderly patients with AMI. The sensitivity and specificity of the four indexes combined for AMI are high, which have certain clinical value.

Key words: urothelial carcinoma antigen 1, lipoprotein a, acute myocardial infarction, diagnostic value, aged