摘要
目的 探究血清脂蛋白(a)[lp(a)]、肌钙蛋白I(cTnI)及和肽素与急性心肌梗死患者预后不良的相关性分析。方法 选取2021年1月~2022年12月收治的70例急性心肌梗死确诊患者,比较所有患者在不同胸痛时间的lp(a)、c TnI及和肽素的水平,并观察急性心肌梗死患者主要不良心血管事件(Major Adverse Cardiac Events,MACE)的发生情况,分为发生不良心血管事件组(MACE组)和未发生不良心血管事件组(非MACE组),采用单因素和多因素分析急性心肌梗死患者发生主要不良心血管事件的独立危险因素,分析lp(a)、cTnI及和肽素的水平预测急性心肌梗死不良预后的价值,为该病早期预测干预提供参考依据。结果 急性心肌梗死患者在胸痛6 h、8 h、12 h、24 h的lp(a)及和肽素水平呈下降的趋势,而cTnI水平则呈上升的趋势(P <0.05);MACE组与非MACE组的Killip分级≥2级、左室射血分数、lp(a)、cTnI及和肽素水平经比较,差异具有统计学意义(P <0.05);经过多因素Logistic回归分析显示,lp(a)、cTnI及和肽素均为急性心肌梗死患者不良预后的独立危险因素(P <0.05);lp(a)、cTnI及和肽素三者均对急性心肌梗死不良预后具有一定的预测价值,且三者联合检测的灵敏度和特异度更高。结论 急性心肌梗死不良预后患者的cTnI水平则呈上升的趋势,lp(a)及和肽素水平均呈下降的趋势,lp(a)、cTnI及和肽素3种元素联合检测对急性心肌梗死患者预后不良预测价值相对较高,可作为急性心肌梗死患者预后不良的重要检测指标,作为临床诊断和治疗的参考依据。
Objective To investigate the correlation between serum lipoprotein(a) [lp(a)],troponin I(cTnI) and copeptin and poor prognosis in patients with acute myocardial infarction.Methods 70 patients diagnosed with acute myocardial infarction were selected from January 2021 to December 2022,and the levels of lp(a),cTnI and copeptin in all patients at different time of chest pain were compared,and the occurrence of major adverse cardiac events(MACE) in patients with acute myocardial infarction were observed.They were divided into two groups:adverse cardiovascular event group(MACE group) and no adverse cardiovascular event group(non-MACE group).Univariate and multivariate analysis was used to analyze the independent risk factors for major adverse cardiac events in patients with acute myocardial infarction,and the value of lp(a),cTnI and copeptin levels in predicting the adverse prognosis of acute myocardial infarction was analyzed.To provide reference for early prediction and intervention of the disease.Results The levels of lp(a) and copeptin in patients with acute myocardial infarction decreased at 6 h,8 h,12 h and 24 h,while the levels of cTnI increased(P<0.05).Analysis showed that Killip grade ≥ 2,left ventricular ejection fraction,lp(a),cTnI and copeptin levels were statistically significant between MACE group and non-MACE group(P<0.05).Multivariate Logistic regression analysis showed that lp(a),cTnI and copeptin were independent risk factors for poor prognosis in patients with acute myocardial infarction(P<0.05).lp(a),cTnI and copeptin have certain predictive value for the adverse prognosis of acute myocardial infarction,and their combined detection has higher sensitivity and specificity.Conclusion cTnI levels in patients with acute myocardial infarction showed an increasing trend,while lp(a) and copeptin levels showed a decreasing trend.The combined detection of lp(a),cTnI and copeptin had relatively high predictive value for adverse prognosis in patients with acute myocardial infarction,and could be used as an im
作者
李方帅
LI Fang-shuai(Department of Cardiology,Laizhou Hospital of Traditional Chinese Medicine,Yantai 261400,China)
出处
《中国处方药》
2023年第8期176-179,共4页
Journal of China Prescription Drug
基金
2021山东中医药高等专科学校科研课题(2021FY03)。
关键词
血清脂蛋白(a)
肌钙蛋白Ⅰ
和肽素
急性心肌梗死
主要不良心血管事件
Serum lipoprotein(a)
Troponin I
Copeptin
Acute myocardial infarction
Major adverse cardiac events Journal of China Prescription Drug Vol.21 No.8
