| 摘要: |
| 目的 检测ST段抬高型急性心肌梗死（STEAMI）患者血浆心肌肌钙蛋白Ⅰ（cTnI）、精氨酸-加压素（AVP）、和肽素（COP）、心钠肽（ANP）、脑钠肽（BNP）、氨基末端脑钠肽原（NT-proBNP）和肾上腺素髓质素（ADM）浓度，探讨其对心肌梗死患者住院期间主要不良心脏事件（MACE）发生的预测价值。方法 收集STEAMI患者和健康体检者各118例，ELISA法检测血浆cTnI、AVP、COP、ANP、BNP、NT-proBNP和ADM浓度，评价和比较其对急性心肌梗死患者住院期间主要MACE发生的预测价值。结果STEAM患者血浆cTnI、AVP、COP、ANP、BNP、NT-proBNP和ADM浓度均显著高于健康体检者（均P＜0.01）。35例（29.7%）出现MACE。MACE患者血浆中上述激素的浓度均显著高于无MACE患者（均P＜0.01）。ROC曲线分析显示，血浆中这些激素水平均可显著预测住院期间MACE发生（均P＜0.01），而COP及NT-proBNP的预测价值优于cTnI（均P＜0.05）。联合检测血浆COP及NT-proBNP可进一步提高血浆COP及NT-proBNP单独检测的预测价值（均P＜0.05）。结论血浆COP及NT-proBNP浓度对STEAMI患者住院期间主要不良心脏事件的预测价值较高，而联合检测血浆COP及NT-proBNP浓度更具有临床价值。 |
| 关键词: 标志物 急性心肌梗死 预后 |
| DOI： |
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| 基金项目:杭州市医药卫生科技计划项目；浙江省医药卫生科技计划项目 |
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| Association of plasma biomarkers with major adverse cardiac events in patients with ST-segment elevation acute myocardial in- farction |
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TANG Bei, ZHONG Ze, WU Xindong, XIANG Peng, SHEN Hongwei
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Jiande First People's Hospital
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| Abstract: |
| Objective To investigate the association of plasma biomarkers with major adverse cardiac events(MACE) in patients with ST-segment elevation acute myocardial infarction(STEAMI). Methods One hundred and eighteen consecutive patients with STEAMI and 118 healthy subjects were enrolled in this study. Plasma cardiac troponin Ⅰ (cTn Ⅰ), arginine vaso- pressin(AVP), copeptin, atrial natriuretic peptide(ANP), brain natriuretic peptide (BNP), N-terminal fragment of pro-brain natri- uretic peptide (NT-proBNP) and adrenomedullin (ADM) levels were measured by ELISA, and their association with in-hospital MACEs of patients was analyzed, Results Plasma cTn I, AVP, copeptin, ANP，BNP, NT-proBNP and ADM levels in STEAMI pa- tients were significantly higher than those in healthy controls (all P＜0.01). MACEs developed in 35 patients(29.7%) during hospi- talization. The plasma levels of these parameters in patients with MACEs were significantly elevated compared with patients with- out MACE (all P＜0.01). ROC curve analysis showed that the predictive value of plasma copeptin and NT-proBNP for MACEs markedly exceeded that of plasma cTn Ⅰ levels (both P ＜0.05), and the combined determination of plasma copeptin and
NT-proBNP further improved the predictive value of (both P＜0.05). Conclusion Plasma copeptin and NT-proBNP levels show high predictive values for occurrences of in-hospital MACEs in STEAMI patients and the combined determination of two biomarkers may further improve their predictive value. |
| Key words: Biomarkers Acute myocardial infarction Prognosis |
