急性心肌梗死发病时心脏标志物与6个月后生存质量的关系

Relationship between the serum cardiac markers in early acute myocardial infarction and health-related quality of life six months later

目的探讨急性心肌梗死（acute myocardial infarction,AMI）患者发病时的心脏标志物与6个月后健康相关生存质量的关系。方法测定106例2004-12~2006-11期间急诊AMI患者发病时N-端脑利钠肽前体（NT-proBNP）、肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK-MB）和乳酸脱氢酶同工酶1（LD1）。6个月后应用SF-36量表对患者的生存质量进行调查,通过多元线性回归分析法筛选出与生存质量有关的标志物。结果SF-36量表总评分和躯体功能、一般健康状况、情感角色等维度评分与NT-proBNP有负线性关系（P均〈0.05）。总评分和躯体角色、肌体疼痛等维度评分与cTnI有负线性关系（P均〈0.05）。躯体功能维度评分与CK-MB有负线性关系（P〈0.05）。结论AMI患者发病时NT-proBNP、cTnI和CK-MB浓度较高,与发病后6个月的生存质量较低有关,三种标志物对生存质量均具有一定的预示作用。

Objective To investigate the relationship between the serum levels of cardiac markers in early acute myocardial infarction （AMI） and health - related quality of life （HRQOL） 6 months later. Methods From Dec. 2004 to Nov. 2006, the serum levels of N - terminal pro - brain natriuretic peptide （ NT - proBNP） , cardiac troponin I （cTnI） , creatine kinase isoenzyme - MB（ CK - MB） and lactate dehydrogenase isoenzyme - 1 （ LD1 ） were obtained from 106 emergency patients with AMI. HRQOL was assessed after 6 months by using the SF -36 health survey questionnaire. Multivariate linear regression analysis was applied to the analysis of data which can identify the cardiac markers associated with HRQOL. Results The total scores of the SF - 36 health survey and the scores of physical functioning＇ general health and role - emotional showed negative linear correlation with NT - proBNP （ P 〈 0.05 ）. The total scores and the scores of role - physical and body pain showed negative linear con＇elation with cTnI （ P 〈 0.05 ）. The scores of physical functioning showed negative linear con＇elation with CK - MB （ P 〈 0.05 ）. Conclusions The high levels of NT- proBNP, cTnI and CK- MB in early AMI was associated with poor HRQOL 6 months later.