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目的探讨肌钙蛋白Ⅰ(cTnⅠ)、血浆脑钠肽(BNP)水平对急性心肌梗死(AMI)患者冠状动脉病变严重程度和近期预后价值的影响。方法入选162例发病6h内AMI患者,并取80例稳定型心绞痛(SAP)患者作为对照组。所有患者于入院后即刻及入院后24h抽肘前静脉血2次,分别行cTnⅠ、BNP检测,取两次结果的最高值,入院期间均完成冠状动脉造影,随访30d并记录其主要心血管不良事件(MACE)。结果 AMI组与SAP组cTnⅠ、BNP水平比较差异有统计学意义(P<0.01);冠状动脉病变程度越严重,其cTnⅠ、BNP水平越高。冠脉三支病变组的cTnⅠ、BNP显著高于双支病变组及单支病变组,冠脉双支病变组的cTnⅠ、BNP显著高于单支病变组,组间比较有统计学意义(P<0.05)。AMI组中发生MACE各组的cTnⅠ、BNP显著高于无症状者。结论 AMI患者中,cTnⅠ、BNP水平的高低对预测冠状动脉病变的严重程度及近期预后有重要价值。
Objective To investigate the effects of cTn Ⅰ and BNP on the severity of coronary artery disease and its prognostic value in patients with acute myocardial infarction (AMI). Methods Sixty-two patients with AMI within 6 hours after onset were enrolled and 80 patients with stable angina pectoris (SAP) were selected as the control group. Immediately after admission and 24h after admission, all patients received 2 venous blood before ankle elbow. The cTn Ⅰ and BNP were measured respectively. The highest value of two results was obtained. All patients underwent coronary angiography during the follow-up period. The patients were followed up for 30 days and their major adverse cardiovascular events Event (MACE). Results The levels of cTnⅠ and BNP in AMI group were significantly different from those in SAP group (P <0.01). The severity of coronary artery disease was more serious, and the levels of cTnⅠ and BNP were higher in AMI group and SAP group. The levels of cTnⅠ and BNP in the three coronary lesions were significantly higher than those in the double-vessel disease and single-vessel disease groups. The levels of cTnⅠ and BNP in the coronary artery disease group were significantly higher than those in the single vessel disease group (P <0.05). In AMI group, cTnⅠ and BNP in MACE group were significantly higher than those in asymptomatic group. Conclusion The level of cTn Ⅰ and BNP in AMI patients is of great value in predicting the severity of coronary artery disease and the prognosis of the patients.