摘要
目的观察急性冠状动脉综合征(ACS)患者住院期间甲状腺激素(TH)、心肌肌钙蛋白Ⅰ(cTnI)和B型钠尿肽(BNP)水平的变化,探讨其与主要不良心脏事件(MACE)发生的关系。方法随机选取ACS患者120例,按照病型分为ST段抬高型心肌梗死(STEMI)、非ST段抬高型心肌梗死(NSTEMI)和不稳定性心绞痛(UA)3个亚组;按照患者住院期间是否再次发生MACE分为发生组[MACE(+)]和未发生组[MACE(-)],分别观察TH、cTnI和BNP水平。结果 NSTEMI组和STEMI组总三碘甲状腺原氨酸(TT3)水平明显低于UA组(P<0.05、P<0.01);NSTEMI组游离三碘甲状腺原氨酸(FT3)水平明显低于STEMI组和UA组(P<0.05)。MACE(+)组TT3和FT3水平明显低于MACE(-)组(P<0.01)。STEMI组、NSTEMI组cTnI水平明显高于UA组(P<0.01),NSTEMI组高于STEMI组(P<0.05),但在MACE(+)和MACE(-)组之间差异无统计学意义(P>0.05)。促甲状腺激素(TSH)、总甲状腺素(TT4)、游离甲状腺素(FT4)和BNP水平在STEMI、NSTEMI和UA 3组间以及MACE(+)和MACE(-)组间差异均无统计学意义(P>0.05)。MACE(+)组cTnI、BNP阳性率与MACE(-)组比较差异无统计学意义(P>0.05)。结论 ACS患者住院期间出现低TT3和FT3水平易发生MACE;cTnI和BNP对ACS患者住院期间发生MACE无提示意义,有待于进一步研究和探讨。
Objective To observe the changes of serum levels of thyroid hormone （TH）, cardiac troponin I （cTnI） and B-type natriuretic peptide（BNP） levels in patients with acute coronary syndrome（ACS） during the hospitalization period, and to study the relationship with major adverse cardiovascular events（MACE）. Methods A total of 120 ACS patients were enrolled randomly and classified into 3 groups including ST-segment elevation acute myocardial infarction （STEMI）, non-ST-segment elevation acute myocardial infarction （NSTEMI） and unstable angina（UA） according to the styles of ACS. According to the patients whether occurred MACE or not during the hospitalization period, 2 groups including MACE（＋） and MACE（-） were classified. TH, cTnl and BNP levels were observed respectively. Results The levels of total triiodothyronine （ TT3 ） in NSTEMI group and STEMI group were significantly lower than that of UA group（ P 〈 0.05, P 〈 0.01 ）. The free triiodothyronine （ FT3 ） level in NSTEMI group was significantly lower than those in STEMI and UA groups（ P 〈 0.05 ）. The levels of T13 and FT3 in MACE（＋） group were significantly lower than those in MACE（-）group（P 〈0.01 ）. The levels of cTnI in STEMI and NSTEMI groops were higher than that in UA group （ P 〈 0.01 ）. The levels of cTnI in NSTEMI group were higher than those in STEMI group （ P 〈 0.05 ） , but no statistical significance was found between MACE（＋） and MACE （-） groups （ P 〉 0.05 ）. Thyroid stimulating hormone （ TSH）, total tetraiodothyronine （33＇4） and free tetraiodothyronine （FT4） and BNP levels had no statistical significance both in STEMI, NSTEMI and UA groups and in MACE（＋） and MACE （-） groups （P 〉 0.05 ）. The positive rates of cTnI and BNP had no statistical significance between MACE （＋） and MACE （-） groups （ P 〉 0.05 ）. Conclusions MACE occurs commonly in the ACS patients with low TT3 and FT3 levels during the hospitalization period. The levels of cTnl and BNP have no significance in the MACE for the ACS patients during the hospitalization period and still are needed further research and study.
出处
《检验医学》
CAS
2012年第12期1054-1057,共4页
Laboratory Medicine
