血清cTnI、CK-MB及Mb在急性心肌梗死冠脉支架介入患者中的临床意义

Clinical significance of serum cTnI,CK⁃MB and Mb in patients with acute myocardial infarction after coronary stent intervention

目的 分析急性心肌梗死(AMI)冠脉支架介入(PCI)患者肌钙蛋白(cTnI)、肌酸激酶同功酶(CK-MB)及肌红蛋白(Mb)水平变化及临床意义。方法 选取2020年4月至2023年6首都医科大学附属北京世纪坛医院收治的135例AMI患者(观察组)作为研究对象,另选取同期进行体检的健康人群100名为对照组。对比对照组与观察组术前、术后血清cTnI、CK-MB、Mb水平;分析影响AMI患者PCI手术成功的单因素;采用多元Logistic回归分析影响AMI患者PCI手术成功的危险因素;采用Pearson分析AMI患者PCI手术成功率与血清cTnI、CK-MB、Mb水平关系。结果 对照组血清c TnI、CK-MB、Mb水平均低于观察组,观察组术前血清c TnI、CK-MB、Mb水平均低于术后,差异有统计学意义(P<0.05);经影像学检查,有112例患者手术成功(82.96%,手术成功组),有23例患者手术未成功(17.04%,手术未成功组);两组年龄、性别、心功能、高血压病史、糖尿病病史、心绞痛病史、PCI术用时等比较,差异无统计学意义(P>0.05);两组发病至入院时间、发病至PCI术时间、血清cTnI、CK-MB、Mb水平等比较,差异有统计学意义(P<0.05);多元Logistic回归分析显示:发病至入院时间>3 h、发病至PCI术时间≥6 h、cTnI≥0.04 ng/mL、CK-MB>5 ng/mL、Mb>50μg/L是影响AMI患者PCI手术成功的危险因素(P<0.05);根据Pearson相关性分析可得:cTnI、CK-MB、Mb水平与AMI患者PCI手术成功率呈负相关(P<0.05)。结论 在AMI患者PCI手术前后血清cTnI、CK-MB、Mb水平变化可反映PCI治疗的治疗疗效,同时可预判患者的预后,检测三指标具有重要的临床意义。

Objective To analyze the changes and clinical significance of serum Cardiac troponin I(cTnI),creatine kinase⁃MB(CK⁃MB)and myoglobin(Mb)levels in patients with acute myocardial infarction(AMI).Methods 135 patients with AMI admitted to Beijing Millennium Temple Hospital affiliated with Capi⁃tal Medical University from April 2020 to June 2023(observation group)were selected as the study subjects.Additionally,100 healthy people who underwent physical examinations during the same period were chosen as the control group.The levels of serum cTnI,CK⁃MB and Mb were compared between the control group and ob⁃servation group before and after the operation.The single factors that affect the success of PCI in AMI patients were analyzed.Multiple logistic regression was used to analyze the risk factors affecting the success of PCI surgery in AMI patients.The relationship between the PCI success rate and serum cTnI,CK⁃MB and Mb levels in AMI patients was analyzed using Pearsons correlation.Results The levels of serum cTnI,CK⁃MB and Mb in the control group were lower than those in the observation group,the levels of serum cTnI,CK⁃MB and Mb in the observation group before surgery were lower than after surgery,with a statistically significant difference(P<0.05).Following imaging examination,112 patients were successfully operated on(82.96%),while 23 patients were unsuccessful(17.04%).The levels of serum cTnI,CK⁃MB and Mb in the observation group before opera⁃tion were higher than after operation,and the differences were statistically significant(P<0.05).There were no significant differences in age,sex,heart function,history of hypertension,diabetes,angina pectoris,and PCI time between the two groups(P>0.05).Comparisons between the two groups included the time from onset to admission,time from onset to PCI,and serum cTnI,CK⁃MB and Mb levels,all of which showed statistically significant differences(P<0.05).Multiple logistic regression analysis revealed that a time from onset to admis⁃sion>3 h,time from onset to PCI≥6h,cTnI≥0.04 ng/mL,CK⁃MB>5 ng/mL,and Mb>50μg/L were risk factors affecting the success of PCI surgery in AMI patients(P<0.05).Pearson correlation analysis indicated that cTnI,CK⁃MB and Mb levels were negatively correlated with the success rate of PCI surgery in AMI pa⁃tients(P<0.05).Conclusion The changes in serum cTnI,CK⁃MB and Mb levels in AMI patients before and after undergoing PCI can indicate the efficacy of PCI treatment and help predict patient prognosis.This holds sig⁃nificant clinical importance.