摘要
目的探讨急性ST段抬高型心肌梗死(STEMI)患者心肌损伤标志物与心肌梗死后心力衰竭的相关性。方法收集2017年本院住院75例STEMI患者的临床资料进行回顾分析。根据院内或心梗后3个月内是否发生心力衰竭分为心衰组(10例)和无心衰组(65例)。分析不同组之间肌钙蛋白I(cTnI)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、α-羟丁酸脱氢酶(HBDH)、氨基末端脑利钠肽(NTproBNP)、左室射血分数(LVEF)、左室舒末径(LVEDD)情况。结果两组之间年龄、心肌梗死部位、直接PCI比例等未发现统计学差异,而心衰组cTnI(13.8±10.8 vs8.0±7.4)ug/L、HBDH(1 022.9±516.0 vs 519.2±353.7)U/L、NTproBNP[3 305.0(2 032.5,8 137.5)vs 1 027.5(438.0,2 027.5)]ng/L明显高于无心衰组,LVEF低于无心衰组(55.9±3.0 vs 60.0±4.6)%,差异有统计学意义,CK、CKMB亦高于无心衰组,但差异无统计学意义。结论 STEMI患者随着cTnI、HBDH及NTproBNP水平的升高,心梗后发生心衰的可能性增加,多项指标联合检测可能有助于预测早期心衰风险。
Objective The aim of study was to investigate the correlation between myocardial injury markers and heart failure in patients with ST-segment elevation acute myocardial infarction （STEMI）. Methods Total 75 patients with STEMI admitted to our hospital in 2017 were included considering the exclusion criteria. According to heart failure occurred whether or not in hospital or discharged within three months, they were divided into two groups-patients with heart failure（GroupⅠ,n=10） and without heart failure（GroupⅡ,n=65）. The myocardial injury markers,troponin I（cTnI）, creatine kinase（CK）, creatine kinase isoenzyme（CKMB）,α-hydroxybutyrate dehydrogenase（HBDH） and N-terminal pro-brain natriuretic peptide（NTproBNP） were routinely measured for all patients after admission,and left ventricular ejection fraction （LVEF） and left ventricular end-diastolic diameter （LVEDD） were also measured in hospital.All patients were followed for 3 months and recorded the occurrence of major adverse cardiac events （MACE）.Results Troponin-I level of GroupⅠ were significantly higher than GroupⅡ（13.8±10.8 vs 8.0±7.4ug/L,P=0.034）.This difference was also found in the two groups of HBDH levels（1022.9±516.0 vs 519.2±353.7U/L,P=0.003）. CK and CKMB levels of patients with heart failure were also higher than those without heart failure, but the differences did not achieve statistical significance.Meanwhile, GroupⅠhad higher NTproBNP level than control group[3305.0（2032.5,8137.5）vs.1027.5（438.0,2027.5）ng/L,p=0.001],and the lower LVEF were detected in GroupⅠcompared with GroupⅡ（55.9±3.0 vs 60.0±4.6%,P=0.012）. Conclusion With the increase of the levels of cTnI, HBDH and NTproBNP in STEMI patients, the risk of heart failure after myocardial infarction is increased. The detection of multiple markers taken after STEMI may be helpful to evaluate the risk of heart failure within 3 months.
作者
尚晨黧
王丽超
高珊
Shang Chenli;Wang Lichao;Gao Shan(Department of Cardiology,The Hospital of Shunyi District,Beijing,101300,China)
出处
《当代医学》
2018年第34期73-75,共3页
Contemporary Medicine
