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目的观察急性心肌梗死(acute myocardial infarction,AMI)患者早期微量蛋白尿(microalbuminuria,MA)的自然变化规律,并对其进行临床相关性研究。方法对连续入选的602例胸痛患者进行研究。所有患者于住院当日、第3天和第7天检查尿微量蛋白肌酐比值,大于或等于300μg/mg定义为MA阳性。同时检查N末端脑钠肽前体(N-terminal B-type brain natriuretic peptide,NT-proBNP)。结果 AMI后MA呈动态变化,心肌梗死后当天即开始升高,第3天达峰,第7天时下降。三个时间点MA阳性率分别为35.9%、50.8%和15.8%。MA的水平和心肌梗死的面积明显相关(r=0.56,P<0.05)。结论 AMI后MA反应性升高,且呈动态变化,其变化与梗死面积和心功能相关。
Objective To observe the natural changes of microalbuminuria (MA) in patients with acute myocardial infarction (AMI) and to investigate its clinical relevance. Methods A total of 602 consecutive patients with chest pain were enrolled in this study. Urine micro-creatinine ratios were examined on the day of hospitalization, on day 3, and day 7 in all patients and greater than or equal to 300 μg / mg was defined as MA positive. At the same time, N-terminal B-type brain natriuretic peptide (NT-proBNP) was examined. Results MA showed a dynamic change after AMI, the day after myocardial infarction began to rise, peaked on the 3rd day, decreased on the 7th day. The positive rates of MA at three time points were 35.9%, 50.8% and 15.8% respectively. The level of MA was significantly correlated with the area of myocardial infarction (r = 0.56, P <0.05). Conclusions After AMI, the reactivity of MA increased with the changes of infarction area and cardiac function.