和肽素在非ST段抬高急性冠脉综合征危险分层中的应用

The Application of the Copeptin in the Risk Stratification of Non-ST Segment Elevation Acute Coronary Syndrome

目的探讨和肽素在非ST段抬高急性冠脉综合征危险分层中的应用。方法收集在我院心内科收治的发病4 h内的非ST段抬高急性冠脉综合征的患者120例(NSTE-ACS组),再随机选取40例有临床症状但造影结果正常的患者为对照组,根据冠脉病变数量及Gensini法对冠脉病变程度进行分组。检测患者发病后4 h、12 h、24 h的血清和肽素水平并进行比较。结果在发病后4 h、12 h、24,患者血浆Copeptin水平明显高于对照组,差异有统计学意义(P<0.05)。随着冠脉病变数量的增加,血Copeptin水平呈现增加的趋势。Pearson相关性分析结果显示:血Copeptin水平与冠脉病变数量呈正相关(r=0.714,P<0.01)。不同冠脉病变数量组内比较差异有统计学意义(F分别为4.56,5.87,5.65,P均<0.05)。随着冠脉狭窄程度的增加,血Copeptin水平也呈现增加的趋势。Pearson相关性分析结果显示:血Copeptin水平与冠脉狭窄程度呈正相关(r=0.641,P<0.01)。不同冠脉狭窄程度的组内比较差异有统计学意义(F分别为4.17,4.31,6.84,P均<0.05)。结论和肽素在非ST段抬高急性冠脉综合征的危险分层中具有较好的诊断价值,值得在临床应用。

OBJECTIVE To observe the application of the Copeptin in the risk stratification of non-ST segment elevation acute coronary syndrome.METHODS 120 patients with suspected non-ST segment elevation acute coronary syndrome within four hours of onset（named the NSTE-ACS Group） were collected in Cardiology of hospital,then randomly selected 40 healthy patients as a control group.The NSTE-ACS Group were grouped according to the method of the number of coronary lesions and coronary lesion in Gensini.The serum copeptin were detected respectively after onset 4h,12 h,24h,and compared with the control group.RESULT After onset 4h,12 h,24h,the serum copeptin was significantly higher than control group,the difference was statistically significant（P〈0.05）.With the increase in the number of coronary artery,the Copeptin levels tended to increase,Pearson correlation analysis showed：Copeptin levels and the number of coronary lesions was positively correlated（r=0.714,P〈0.01）.The difference between each two groups was statistically significant（F respectively was 4.56,5.87,5.65,P〈0.05）.With the increasing degree of coronary stenosis,Copeptin levels also tended to increase,Pearson correlation analysis showed：Copeptin levels and the degree of coronary stenosis was positively correlated（r=0.741,P〈0.01）.The difference between each two groups was statistically significant（F respectively was 4.56,5.87,5.65,P〈0.05）.CONCLUSION The diagnostic sensitivity of Copeptin in non-ST segment elevation acute coronary syndrome was superior to sensitive troponin I,with a good diagnostic value,which was worthy of clinical application.