ST段抬高性心肌梗死急性期心脏标记物与六个月后生存质量的关系

Relationship between the cardiac markers in ST-segment elevation myocardial infarction and quality of life six months later

目的探讨ST段抬高性心肌梗死（STEMI）急性期的心脏标记物与6个月后生存质量的关系。方法测定76例STEMI患者入院时（0h）和发病24h的N-末端脑利钠肽前体（NT-proBNP）、心肌肌钙蛋白I（cTnI）、肌酸激酶同工酶MB（CK-MB）、肌红蛋白（Myo）。6个月后应用SF-36量表进行生存质量调查，通过多元线性回归分析法筛选出与生存质量有关的心脏标记物。结果SF-36量表总评分和生理功能、躯体疼痛、一般健康状况评分与入院时（0h）和发病24h的NT-proBNP呈负相关（P〈0．05）；SF-36量表总评分、生理功能和躯体疼痛评分与入院时（0h）和发病24h的cTnI呈负相关（P〈0．05）；SF-36量表总评分与躯体疼痛评分仅与发病24h的CK-MB呈负相关（P〈0．05）。生命活力评分仅与入院时（0h）的Myo呈负相关（P〈0．05）。结论STEMI急性期的心脏标记物水平越高，可能预示其6个月后的生存质量越低。

Objective To study the relationship between the cardiac markers in ST-segment elevation myocardial infarction （STEMI） and quality of life （QOL） six months later. Methods N-terminal pro-B-type natriuretic peptide （NT-proBNP）, cardiac troponin I （cTnI）, creatine kinase isoenzyme-MB （CK-MB） and myoglobin（Myo） was tested in 76 patients with STEMI on admission（0 h ） and 24 h after admission. QOL six months later was evaluated by using the SF-36 health survey questionnaire.The relationship between the cardiac markers and QOL was analyzed by multivariate linear regression analysis. Results The total SF-36 scores and the scores of physical function, body pain and general health showed negative linear correlation with NT-proBNP on admission （0 h ） and 24 h after admission （P〈 0.05）. The total SF-36 scores and the scores of physical function and body pain showed negative linear correlation with eTnI on admission （0 h） and 24 h after admission （P 〈 0.05 ）. The total SF-36 scores and the scores of body pain showed negative linear correlation with CK-MB on 24 h after admission （P 〈 0.05）. The scores of vitality showed negative linear correlation with Myo on admission （0 h ） （P 〈 0.05 ）. Conclusion The higher levels of NT-proBNP, eTnI and CK-MB indicate the lower QOL six months later.