联检BNP和cTnI在AMI诊断及预后中的应用

Clinical Application of Combined Determination of BNP and cTnI for Diagnosis and Outcome Prediction in Patients with Acute Myocardial Infarction (AMI)

目的:探讨血浆脑钠肽(BNP)和血清心肌蛋白I(cTnI)联检在急性心肌梗死(AM I)诊断及预后中的作用。方法:用ELISA测定血浆BNP,用ACCESS全自动磁微粒子化学发光仪测定血清cTnI。结果:AM I组BNP和cTnI的均值与正常对照组有显著性差异(P<0.01),AM I患者BNP开始升高时间(5.0±2.6)h稍缓于cTnI(4.0±2.8)h;连续治疗14d后,有22例BNP>80ng/L,有2例cTnI>0.1μg/L,但cTnI值<1.0μg/L。结论:血浆BNP和血清cTnI的联检是诊断AM I的高度敏感、特异性高的生物指标,AM I预后BNP比cTnI更有临床参考价值。

Objective To investigate the significance of combined determination of plasma brain natriuretic peptide （BNP） and serum cardic troponin I （cTnI） for diagnosis and outcome prediction in patients with AMI. Methods Plasma BNP （with ELISA） and cTnI （with magnetic particle CLIA） levels were determined in 50 controls and 42 patients with AMI at admission. The levels were followed dynamically q. 4. h. × 6, then q. d for two weeks in the patients. Results The plasma levels of BNP and cTnI were significantly higher in the patients than those in controls （P 〈 0.01）. The BNP levels exceeded the diagnostic cut - off value slightly later than the cTnI levels did （5.0±2.6 h vs 4.0±2.8 h）. On d14, 22 of the 42 patients still had their BNP levels over the 80ng/L, cut - off value while only 2 patients had their cTnI levels over the 0.1 μg/L, cut - off value （between 0.1 and 1.0μg/L） （interestingly, in one of the two patients, BNP levels was still very hihg - 〉400ng/L）. Conclusion Elevation of BNP after AMI persisted much longer than cTnI did and was of more prognostic value.