急性心肌梗死病人血清肌钙蛋白T动态变化及其与病人预后的关系

DYNAMIC FLUCTUATION OF SERUM TROPNIN-T AND ITS RELATIONSHIP WITH PROGNOSIS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

①目的 探讨急性心肌梗死 (AMI)病人血清肌钙蛋白T(TnT)的动态变化及其与病人近期预后的关系。②方法 采用一步夹心免疫吸附分析法 (ELISA)测定AMI、不稳定心绞痛 (UAP)病人及 6 0例健康人血清TnT的动态变化 ,采用免疫抑制酶动力学方法测定肌酸激酶同工酶MB(CK MB)活性 ,并观察病人心脏事件和并发症发生情况。③结果 AMI病人TnT水平明显高于UAP组及健康对照组 (F =1 5 2 .36 ,q =2 1 .2 2、2 1 .77,P <0 .0 1 )。AMI时TnT释放呈两种曲线特征 ,其中Ⅰ组 (TnT 1峰 / 2峰比值 >1 )AMI并发症的发生率明显低于Ⅱ组(TnT 1峰 / 2峰比值≤ 1或TnT呈单峰曲线 ) ,差异有显著性 (χ2 =7.2 0 ,P <0 .0 5 )。AMI组TnT峰值与CK MB峰值水平呈显著正相关 (r =0 .71 ,P <0 .0 1 )。④结论 TnT是反映心肌损伤较好的指标 ,可较准确地评估AMI病人近期预后。

Objective To investigate the dynamic fluctuation of serum Tropnin-T(TnT) and its relationship with short-term prognosis in patients with acute myocardial infarction(AMI). Methods The dynamic change of serum TnT was measured with one-step enzyme-linked immunosorbent assay(ELISA) in patients with AMI and unstable angina pectoris(UAP) and 60 normal controls. Creatine kinase isoenzyme MB(CK-MB) activities were measured with immunosuppressive enzyme kinetics and heart-related affairs and complications observed. Results TnT level in AMI patients was significantly higher than that in UAP and normal controls ( F=152.36; q=21.22, 21.77; P <0.01). When AMI occurred, the release of TnT demonstrated two types of curves, in which GroupⅠ(TnT peak 1/peak 2>1) had a significantly lower AMI complication than Group Ⅱ(TnT peak 1/peak 2≤1 or TnT level showing single curve) ( χ 2=7.20, P <0.05). TnT peak level in AMI was co-related with CK-MB peak level ( r= 0.71, P <0.05). Conclusion TnT is a valuable index for myocardial lesions, which could be used to assess precisely the short-term prognosis of AMI patients.