心肌梗死患者血清cTnI、CK-MB、CRP水平变化及与心肌微循环状态的关系

Changes of serum cTnI,CK-MB and CRP levels in patients with myocardial infarction and their relationship with myocardial microcirculation

目的探讨心肌梗死患者血清心肌肌钙蛋白(cTnI)、肌酸激酶同工酶MB(CK-MB)、C-反应蛋白(CRP)水平变化及与心肌微循环状态的关系。方法选取2018年6月至2021年3月首都医科大学附属北京世纪坛医院收治的90例心肌梗死患者作为心肌梗死组,并根据患者心电图ST段有无抬高分为ST段抬高组(STEMI)38例和非ST段抬高组(NSTEMI)52例,选取同期来院体检的80例健康人作为健康对照组,检测各组血清cTnI、CK-MB和CRP水平,并分析三者与心肌微循环状态的关系。结果心肌梗死组血清cTnI、CK-MB、CRP水平均高于健康对照组,差异有统计学意义(P<0.05)。STEMI组血清cTnI、CK-MB、CRP水平均高于NSTEMI组,差异有统计学意义(P<0.05)。心肌梗死组甲襞微循环输入支管径、输出支管径和血流速度均小于健康对照组,差异有统计学意义(P<0.05)。STEMI组甲襞微循环输入支管径、输出支管径和血流速度均小于NSTEMI组,差异有统计学意义(P<0.05)。心肌梗死组微循环指标均与血清cTnI、CK-MB、CRP水平呈负相关(P<0.05)。结论心肌梗死患者血清cTnI、CK-MB、CRP水平较健康人群高,且与心肌微循环呈负相关,临床可将其作为诊断心肌梗死患者心肌微循环状态的参考指标。

Objective To explore the changes of serum cardiac troponin(cTnI),creatine kinase MB(CK-MB)and C-reactive protein(CRP)levels in patients with myocardial infarction and their relationship with myocardial microcirculation.Methods 90 patients with myocardial infarction admitted to Beijing Shijitan Hospital,Capital Medical University from June 2018 to March 2021 were selected as the myocardial infarction group.According to the presence or absence of electrocardiogram ST-segment elevation,the patients were divided into the ST-segment elevation group(STEMI group,38 cases)and the non-ST-segment elevation group(NSTEMI group,52 cases).And 80 healthy people who came to the hospital for physical examination during the same period were selected as the healthy control group.The levels of serum c TnI,CK-MB and CRP were detected in each group,and the relationship between the above three levels and myocardial microcirculation status was analyzed.Results The levels of serum cTnI,CK-MB and CRP in the myocardial infarction group were higher than those in the healthy control group(P<0.05).The levels of serum cTnI,CK-MB and CRP in the STEMI group were higher than those in the NSTEMI group(P<0.05).The input branch diameter,output branch diameter and blood flow velocity of nailfold microcirculation were shorter or slower in the myocardial infarction group than those in the healthy control group(P<0.05).The input branch diameter,output branch diameter and blood flow velocity of nailfold microcirculation in the STEMI group were shorter or slower compared with those in the NSTEMI group(P<0.05).The microcirculation indicators in the myocardial infarction group were negatively correlated with serum c Tn I,CK-MB and CRP(P<0.05).Conclusion The levels of serum c Tn I,CK-MB and CRP in patients with myocardial infarction are higher than those in healthy people and they are negatively correlated with myocardial microcirculation.They can be used as reference indicators for clinical diagnosis of myocardial microcirculation in patients with myocardial infarction.