肌钙蛋白T、脑钠肽与急性心肌梗死并发心功能衰竭严重程度的相关性及预后预测

摘要/Abstract

摘要： 目的探讨肌钙蛋白T（cTnT）、脑钠肽（BNP）与急性心肌梗死并发心功能衰竭严重程度的相关性及预后预测。方法选取2022年1月—2022年12月江门市人民医院收治的100例急性心肌梗死并发心功能衰竭患者作为研究对象,应用Killip分级进行分组,Ⅰ级组16例,Ⅱ级组23例,Ⅲ级组34例,Ⅳ级组27例,选取同期江门市人民医院体检的50名健康志愿者作为对照组,比较5组患者cTnT、BNP表达水平,分析cTnT、BNP与急性心肌梗死并发心功能衰竭严重程度的相关性。随后将100例急性心肌梗死并发心功能衰竭患者中院内死亡者分为死亡组（32例）,将其余患者分为存活组（68例）,比较两组患者临床一般情况,分析cTnT、BNP对急性心肌梗死并发心功能衰竭预后的预测价值。结果 5组患者cTnT、BNP水平比较,差异有统计学意义（P<0.05）,Ⅳ级组患者明显高于Ⅲ级组、Ⅱ级组、Ⅰ级组和对照组,差异有统计学意义（P<0.05）;Spearman相关分析结果显示,cTnT、BNP与急性心肌梗死并发心功能衰竭严重程度呈正相关（P<0.05）;存活组与死亡组患者性别、年龄、BMI、合并糖尿病、高血压、高脂血症、左心室射血分数、支架数、支架长度比较,差异无统计学意义（P>0.05）,存活组与死亡组患者Killip分级、合并陈旧性心肌梗死、cTnT、BNP水平比较,差异有统计学意义（P<0.05）;logistic回归分析结果表明,cTnT、BNP为急性心肌梗死并发心功能衰竭预后的独立预测指标（P<0.05）。结论 cTnT、BNP与急性心肌梗死并发心功能衰竭严重程度具有明显关系,且能够通过cTnT、BNP反应水平来预测急性心肌梗死并发心功能衰竭患者的预后情况。临床可以考虑对cTnT、BNP升高的急性心肌梗死并发心功能衰竭患者及时调整治疗方案,进一步降低患者病死率。

关键词: 肌钙蛋白, 脑钠肽, 急性心肌梗死, 心功能衰竭, 相关性, 预后预测

Abstract: Objective To investigate the correlation between cardiac troponin （cTnT）, brain natriuretic peptide （BNP） and the severity of acute myocardial infarction （AMI） complicated with heart failure, and to predict the prognosis. Methods A total of 100 patients with acute myocardial infarction complicated with heart failure admitted to our hospital from January 2022 to December 2022 were selected as the study objects. All patients were divided into 16 patients of grade I, 23 patients of grade II, 34 patients of grade III, and 27 patients of grade IV. 50 healthy volunteers who came to our hospital for physical examination at the same time were selected as the control group. The expression levels of cTnT and BNP in five groups of patients were compared, and cTnT, BNP were analyzed The correlation between BNP and the severity of acute myocardial infarction complicated with heart failure. Then 100 patients with acute myocardial infarction complicated by heart failure were divided into death group （n=32） and survival group （n=68）. The general clinical conditions of the two groups were compared, and the prognostic value of cTnT and BNP for the prognosis of acute myocardial infarction complicated by heart failure was analyzed. Results The levels of cTnT and BNP in the five groups were significantly higher than those in the three groups （P<0.05）; Spearman correlation analysis showed that cTnT and BNP were positively correlated with the severity of acute myocardial infarction complicated with heart failure （P<0.05）; There was no significant difference in sex, age, BMI, diabetes, hypertension, hyperlipidemia, left ventricular ejection fraction, number of stents, and length of stents between the survival group and the death group （P>0.05）. There was significant difference in Killip grade, old myocardial infarction, cTnT, and BNP levels between the survival group and the death group （P<0.05）; The above indexes with statistical difference in univariate analysis were assigned. The results of logistic regression analysis showed that cTnT and BNP were independent predictors of the prognosis of acute myocardial infarction complicated with heart failure （P<0.05）. Conclusion Cardiac troponin and brain natriuretic peptide have obvious relationship with the severity of acute myocardial infarction complicated with heart failure, and can predict the prognosis of patients with acute myocardial infarction complicated with heart failure by cTnT and BNP reaction levels. In order to further reduce the mortality of patients with acute myocardial infarction （AMI） complicated by heart failure （HF） with elevated cTnT and BNP, we can consider adjusting the treatment plan in time.

Key words: troponin, brain natriuretic peptide, acute myocardial infarction, heart failure, relevance, prognostic prediction

中图分类号:

R542.2+2

吴耀庆, 吴木富, 冯炎锋. 肌钙蛋白T、脑钠肽与急性心肌梗死并发心功能衰竭严重程度的相关性及预后预测[J]. 中华养生保健, 2023, 41(14): 177-181.

WU Yao-qing WU Mu-fu FENG Yan-feng. Correlation between Cardiac Troponin, Brain Natriuretic Peptide and Severity of Acute Myocardial Infarction Complicated with Heart Failure and Prognosis Prediction[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(14): 177-181.

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