急性心肌梗死后心力衰竭患者血清cTnI、MYO、BNP水平与心室重塑及预后的关系

Relationship between Serum cTnI, MYO, BNP Levels and Ventricular Remodeling, Prognosis in Patients with Heart Failure after Acute Myocardial Infarction

目的探讨急性心肌梗死(AMI)后心力衰竭(HF)患者血清心肌肌钙蛋白I(cTnI)、肌红蛋白(MYO)、脑钠肽(BNP)水平与心室重塑及预后的关系。方法选择2019年1月至2021年1月收治的106例AMI后HF患者作为研究组,根据预后情况又分为预后不良组(n=28)、预后良好组(n=78),并另选取同期60例健康体检者作为对照组。检测所有受试者血清c TnI、MYO、BNP水平,采用超声心动图检测心室重塑参数[左室舒张末期内径(LVEDD)、左心房内径(LAD)、左室射血分数(LVEF)、左心室质量指数(LVMI)],采用Pearson相关系数分析AMI后HF患者血清cTnI、MYO、BNP水平与心室重塑参数的相关性,采用受试者操作特征(ROC)曲线分析血清cTnI、MYO、BNP水平预测AMI后HF患者预后的价值。结果研究组血清cTnI、MYO、BNP水平均高于对照组(P<0.05);研究组LVEDD、LAD、LVMI均高于对照组,LVEF低于对照组(P<0.05)。Pearson相关性分析结果显示,AMI后HF患者血清cTnI、MYO、BNP水平与LVEDD、LAD及LVMI均呈正相关,与LVEF均呈负相关(P<0.05);预后不良组血清cTnI、MYO、BNP水平均高于预后良好组(P<0.05)。血清cTnI、MYO、BNP联合预测AMI后HF患者预后的AUC为0.931,高于三者单独预测的0.759、0.735、0.746(P<0.05)。结论AMI后HF患者血清cTnI、MYO、BNP水平均明显升高,三者均与心室重塑密切相关,联合检测血清cTnI、MYO、BNP水平能辅助预测AMI后HF患者预后。

Objective To explore the relationship between serum cardiac troponin I(cTnI),myoglobin(MYO),brain natriuretic peptide(BNP)levels and ventricular remodeling,prognosis in patients with heart failure(HF)after acute myocardial infarction(AMI).Methods A total of 106 patients with HF after AMI in the hospital were enrolled as study group between January 2019 and January 2021.According to different prognosis,they were divided into poor prognosis group(n=28)and good prognosis group(n=78).Other 60 healthy controls during the same period were enrolled as control group.The levels of serum cTnI,MYO and BNP in all objects were detected.The ventricular remodeling parameters[left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD),left ventricular ejection fraction(LVEF),left ventricular mass index(LVMI)]were measured by echocardiography.The correlation between serum cTnI,MYO,BNP levels and ventricular remodeling parameters in HF patients after AMI was analyzed by Pearson correlation coefficient.The prognostic value of serum cTnI,MYO and BNP levels was analyzed by receiver operating characteristic(ROC)curves.Results The levels of serum cTnI,MYO and BNP in study group were higher than those in control group(P<0.05).LVEDD,LAD and LVMI in study group were higher than those in control group,and LVEF in study group was lower than that in control group(P<0.05).The results of Pearson correlation analysis showed that levels of serum cTnI,MYO and BNP were positively correlated with LVEDD,LAD and LVMI,while negatively correlated with LVEF(P<0.05).The levels of serum cTnI,MYO and BNP in poor prognosis group were higher than those in good prognosis group(P<0.05).According to ROC curves,AUC of serum cTnI combined with MYO and BNP for predicting prognosis of HF patients after AMI was 0.931,greater than that of them alone(0.759,0.735,0.746)(P<0.05).Conclusion The levels of serum cTnI,MYO and BNP are significantly increased in HF patients after AMI.The three indexes are closely related to ventricular remodeling,and their combined detection is beneficial to predict prognosis of HF patients after AMI.