摘要
目的检测血浆同型半胱氨酸(Hcy)、血浆脑钠肽(BNP)、肌酸激酶同工酶(CK-MB)在急性冠脉综合征(ACS)患者治疗前后中的水平变化及对预后评价的意义。方法选取承德医学院附属医院2017至2019年急诊科收治的ACS患者120例为观察组,其中不稳定心绞痛组(UAP组)60例,急性心肌梗死组(AMI组)60例,同期健康体检者60例作为对照组。监测2组血浆同型半胱氨酸、血浆脑钠肽、肌酸激酶同工酶水平及患者治疗前后的变化。结果UAP组血浆Hcy水平为(16.75±4.38)μmol/L,AMI组血浆Hcy水平为(23.14±3.56)μmol/L,对照组血浆中Hcy水平为(6.67±0.78)μmol/L,ACS组较对照组Hcy、BNP、CK-MB水平均升高(P<0.01),AMI组较UAP组升高更明显,且治疗后较治疗前比较,Hcy、BNP、CK-MB水平明显下降,差异有统计学意义(P<0.01),血浆Hcy、BNP、CK-MB水平与ACS患者病变严重程度的直线回归分析显示,血浆Hcy与BNP、CK-MB、收缩压呈正相关(r=0.271、0.268、0.439,均P<0.05),与年龄、舒张压、TC、TG、LDL-C、HDL-C无相关性(P>0.05)。结论血浆同型半胱氨酸联合心肌标志物血浆脑钠肽、肌酸激酶同工酶检测在ACS患者中明显升高,且治疗后较治疗前水平明显下降,三者联合检测对早期治疗及观察预后具有重要的指导意义。
Objective To investigate the significance of combination detection of plasma homocysteine(Hcy),plasma brain natriuretic peptide(BNP)and creatine kinase isoenzyme(CK-MB)in prognosis evaluation of patients with acute coronary syndrome(ACS).Methods A total of 120 patients with ACS who were admitted and treated in our hospital from 2017 to 2019 were enrolled as observation group,including 60 patients in unstable angina group(UAP group),and 60 patients in acute myocardial infarction group(AMI group),at the same time,60 healthy subjects who underwent physical examination were enrolled as control group.The levels of plasma Hcy,BNP and CK-MB before and after treatment were detected.Results The levels of Hcy,BNP,CK-MB in USP group and AMI group were significantly higher than those in control group(P<0.01),moreovermwhich in AMI group were significantly higher than those in UAP group,however,which were significantly decreased after treatment(P<0.01).Linear regression analysis showed that the levels of Hcy,BNP,CK-MB were positively correlated with the severity of patients with ACS(P<0.05),however,which were not related with patient’s age,and the levels of diastolic blood pressure,TC,TG,LDL-C,HDL-C(P>0.05).Conclusion The levels of plasma Hcy,BNP and CK-MB in patients with ACS are significantly increased,moreover,which are significantly decreased after treatment.The combination detection of the three indexes has important guiding significance for early treatment and observation of prognosis.
作者
李富利
赵艳军
于健
王一冰
LI Fuli;ZHAO Yanjun;YU Jian(Emergency Department,Affiliated Hospital of Chengde Medical College,Hebei,Chengde 067000,China)
出处
《河北医药》
CAS
2021年第3期394-396,400,共4页
Hebei Medical Journal
基金
承德市科学技术研究与发展支撑计划项目(编号:201801A035)。
