急性心肌梗死患者cTnI、D-D、BNP和心肌酶谱变化及临床意义

Changes and clinical significance of cardiac troponin I, D-Dimer, B-type natriuretic peptide, and myocardial enzymes in patients with acute myocardial infarction

目的 探讨急性心肌梗死患者肌钙蛋白(cTnI)、D-二聚体(D-D)、B型利钠肽(BNP)和心肌酶谱变化及其临床意义。方法 回顾性选取2018年1月至2020年1月吴川市人民医院收治的87例急性心肌梗死患者作为观察组,选取同期于我院体检的87例受检者作为对照组。比较两组受检者的cTnI、D-D、BNP及心肌酶谱指标乳酸脱氢酶(LDH)、谷草转氨酶(AST)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)水平,采用多元Logistic回归分析cTnI、D-D、BNP、心肌酶谱水平与急性心肌梗死发病的关系。结果 观察组患者的cTnI、D-D、BNP水平分别为(6.23±1.43)μg/L、(1.34±0.24) mg/L、(603.71±10.76) ng/L,明显高于对照组的(0.08±0.02)μg/L、(0.27±0.05) mg/L、(32.27±1.48) ng/L,差异均有统计学意义(P<0.05);观察组患者的心肌酶谱指标LDH、AST、CK-MB、CK水平分别为(572.62±12.43) U/L、(61.53±10.13) U/L、(23.75±4.27) U/L、(190.28±15.73) U/L,明显高于对照组的(217.47±6.84) U/L、(19.61±3.36) U/L、(9.68±1.54) U/L、(49.35±5.28) U/L,差异均有统计学意义(P<0.05);经多元Logistic回归分析结果显示,cTnI、D-D、BNP、心肌酶谱水平均为急性心肌梗死发生的独立危险因素(P<0.05)。结论 急性心肌梗死患者cTnI、D-D、BNP及心肌酶谱水平显著升高,cTnI、D-D、BNP及心肌酶谱水平均为急性心肌梗死的独立危险因素。

Objective To investigate the changes and clinical significance of cardiac troponin I(cTnI), D-Dimer(D-D), B-type natriuretic peptide(BNP), and myocardial enzymes in patients with acute myocardial infarction.Methods Eighty-seven patients with acute myocardial infarction admitted in Wuchuan People’s Hospital from January2018 to January 2020 were selected as the observation group, and 87 patients with physical examination in our hospital during the same period were selected as the control group. The levels of c TnI, D-D, BNP, myocardial enzymes lactate dehydrogenase(LDH), aspartate aminotransferase(AST), creatine kinase isoenzyme(CK-MB), and creatine kinase(CK)were compared between the two groups. Multivariate Logistic regression analysis was used to analyze the relationship between the levels of cTnI, D-D, BNP and myocardial enzyme spectrum and the incidence of acute myocardial infarction. Results The levels of c TnI, DD and BNP in the observation group were(6.23±1.43) μg/L,(1.34±0.24) mg/L, and(603.71±10.76) ng/L, respectively, which were significantly higher than(0.08±0.02) μg/L,(0.27±0.05) mg/L,(32.27±1.48) ng/L in the control group(P<0.05). The levels of myocardial enzymes LDH, AST, CK-MB and CK in the observation group were(572.62±12.43) U/L,(61.53±10.13) U/L,(23.75±4.27) U/L,(190.28±15.73) U/L, which were significantly higher than(217.47±6.84) U/L,(19.61±3.36) U/L,(9.68±1.54) U/L,(49.35±5.28) U/L in the control group(P<0.05). Multiple regression Logistic analysis showed that c TnI, D-D, BNP, and myocardial enzyme spectrum levels were independent risk factors for acute myocardial infarction(P<0.05). Conclusion The levels of c TnI, D-D, BNP and myocardial enzymes in patients with acute myocardial infarction are significantly increased, and the levels of c TnI, D-D,BNP and myocardial enzymes are independent risk factors of acute myocardial infarction.