急性心肌梗死患者血清和肽素心肌肌钙蛋白I B型钠尿肽超敏C反应蛋白临床研究

Clinical study of copeptin, cardiac troponin I, BNP and high sensitivity C reactive protein in patients with acute myocardial infarction

目的 探讨急性心肌梗死患者血清和肽素、心肌肌钙蛋白I、B型钠尿肽、超敏C反应蛋白水平的变化.方法 将41例急性心肌梗死患者设为观察组,选取同期30名健康体检者设为对照组.观察组于入院时、入院后12 h、48 h、1周采集外周静脉血检测血浆和肽素、B型钠尿肽、超敏C反应蛋白水平及血清心肌肌钙蛋白I水平;对照组于体检当天采集外周静脉血检测上述指标.结果 观察组入院后1周和肽素、B型钠尿肽、超敏C反应蛋白水平均显著低于入院时（P〈0.05）,入院后12 h、48 h及入院后1周的心肌肌钙蛋白I水平显著高于入院时（P〈0.05）;入院时、入院后12 h、48 h各项指标水平均显著高于对照组（P〈0.05）;入院后1周心肌肌钙蛋白I、B型钠尿肽水平仍显著高于对照组（P〈0.05）,而和肽素、超敏C反应蛋白水平与对照组比较差异无统计学意义（P〉0.05）.观察组入院时左主干病变患者和肽素、B型钠尿肽水平均显著高于单支病变、双支病变和三支病变患者（P〈0.05）,心肌肌钙蛋白I水平显著低于单支病变、双支病变和三支病变患者（P〈0.05）.结论 联合检测血清和肽素、心肌肌钙蛋白I、B型钠尿肽、超敏C反应蛋白可有效反映急性心肌梗死患者的病情变化情况,尤其是和肽素和心肌肌钙蛋白I的检测,对急性心肌梗死的诊断和病情的评估有重要意义.

Objective To investigate the changes of copeptin, cardiac troponin I, type B natriuretic peptide （BNP） and hypersensitive C reactive protein （hs-CRP） in patients with acute myocardial infarction （AMI）. Methods 41 patients with acute myocardial infarction were selected as observation group, 30 healthy volunteers were selected as control group, the level of peptide, cardiac troponin I, BNP, hs-CRP and serum cardiac troponin I in observation group at admission, 12h after admission, 48h after admission and 1 week after admission were determined, while in control group, the above indexes were detected on the day of physical examination. Results The level of copeptin, BNP and hs-CRP in observation group at 1 week after admission were significantly lower than those at admission （P〈0.05）, cardiac troponin I at 12 h, 48 h and 1 week after admission were significantly higher than that at admission （P〈0.05） ; each index level at admission, 12 h, 48 h after admission were all significantly higher than that in control group （P〈0. 05）;cardiac troponin I, BNP of observation group at 1 week after admission were still higher than those in control group （P〈0.05）, and difference of copeptin, hs-CRP between observatim- group and con- trol group had no statistic significance （P〉0.05）. The levels of BNP in patients with left main diseases were significantly higher than those of single vessel lesions, double vessel lesions and three branches （P〈 0.05）. The level of cardiac troponin I in patients with left main coronary artery disease was lower than that in patients with single vessel disease, double vessel disease and three branch lesions （P〈0.05）. Conclusion Serum copeptin, cardiac troponin I, BNP and hs-CRP in patients with acute myocardial infarction can effectively reflect the condition changes, especially the copeptin and I detection of cardiac troponin, has important significance in diagnosis and evaluation of acute myocardial infarction.