急性心肌梗死介入治疗前后血清cTnI、BNP、IMA浓度变化的意义

The clinical meanings of the change of serum cTnI,BNP and IMA before and after PCI treatment in the patients with acute myocardial infarction

目的:探讨急性心肌梗死(AMI)患者在PCI治疗前后血清肌钙蛋白I(cTnI)、脑钠肽(BNP)、缺血修饰白蛋白(IMA)的浓度变化及意义。方法:选取经PCI治疗的AMI患者35例,治疗前及治疗后6 h检测血清cTnI、BNP、IMA浓度,进行比较、评价。结果:(1)病例组血清cTnI[(50.53±29.95)ng/ml]、BNP[(5.01±1.23)mg/ml]、IMA[(1449.47±213.49)nmol/L]浓度较健康对照组显著升高(t=10.94,P<0.001;t=28.46,P<0.001;t=42.33,P<0.001)。(2)AMI患者经PCI治疗后6 h血清cTnI浓度[(47.02±28.11)ng/ml]与治疗前[(49.59±33.17)ng/ml]差别无统计学意义(t=1.625,P>0.05),但BNP浓度[(6.64±4.37)mg/ml]、IMA浓度[(1908.85±780.30)nmol/L]较治疗前[(5.06±1.16)mg/ml]、IMA[(1463.32±239.13)nmol/L]明显升高(t=-2.387,P<0.05;t=-3.311,P<0.01)。结论:PCI治疗前后血清cTnI浓度无明显变化,而BNP、IMA浓度较治疗前升高,提示PCI对AMI患者造成一过性心肌损伤,这些指标对AMI患者PCI治疗后心肌损伤监测及治疗有重要意义。

Objective：To observe and analyze the changes of serum cTnI, BNP and IMA before and after PCI treatment in the patients with acute myocardial infarction （AMI）. Methods： 35 patients with acute myocardial infarction （AMI）, who had re- ceived percutaneous coronary intervention（PCI） treatment, were selected to measure the levels of cTnI, BNP and IMA before and 6 hours after PCI treatment respectively and the results were compared and evaluated. Results： （1）The level of serum cTnI [ （50.53 ±29.95）ng/ml] ,BNP[ （5.01 ± 1.23） mg/ml] and IMA [ （ 1449.47 ± 213.49 nmol/Ll in patients with AMI were higher than those in healthy controls. And there was statistical difference between them t = 10.94, P 〈 0. 001 ; t = 28.46, P 〈 0.001 ;t = 42.33, P 〈 0. 001 ）. （2） The level of serum cTnI [ （47.02± 28.11 ） ng/ml ] 6 hours after PC I was lower than the level of cTnI [ （49.59 ± 33.17 ） ng/ml ] before PCI. And there was no statistical difference between them （t = 1. 625, P 〉 0.05）. But the level of serum BNP[ （6.64 ± 4.37 ）mg./ml ] and IMA [ （1908.85 ±780.30）nmol/L ] six hours after PCI treatment were higher than the level of serum BNP [ （5.06 ± 1.16） mg/ml ] and IMA [ （ 1463.32 ± 239.13 ） nmol/L ] before PCI treatment. And there was statistical difference between them（ t = - 2. 387, P 〈 0.05 ; t = - 3.311, P 〈 0.01 ）. Conclusion： The level of serum cTnI six hours after PCI had no significant change with the leyel of it before PCI,but the level of BNP and IMA were higher than before, The change prompted that the AMI patients had the symptoms of myocardial injury after PCI, The changes of the level of serum cTnI, BNP and IMA have important significance in the judgement of severity and observation of curative effect for the patients with AMI, who had received PCI treatment.