血清NT⁃proBNP、cTnI及CK⁃MB与急性心梗患者近期预后的关系

Relationship between serum NT⁃proBNP,cTnI and CK⁃MB and short⁃term prognosis of patients with acute myocardial infarction

目的探讨血清N末端钠尿肽原(NT⁃proBNP)、心肌肌钙蛋白Ⅰ(cTnⅠ)及肌酸激酶同工酶(CK⁃MB)与急性心梗患者近期预后的关系。方法选取2019年1月至2021年1月首都医科大学附属北京世纪坛医院收治的98例急性心梗患者为研究组,根据患者随访期间是否发生不良心血管事件分为预后不良组和预后良好组,另选取同时间段进行健康体检的83例健康志愿者为对照组。比较不同人群血清NT⁃proBNP、cTnI及CK⁃MB水平,分析NT⁃proBNP、cTnI、CK⁃MB及三者联合检测对急性心梗患者近期预后的预测价值。结果研究组NT⁃proBNP、cTnI及CK⁃MB水平均明显高于对照组,差异均具有统计学意义(P<0.05)。随访期间共33例患者预后不良,65例患者预后良好。预后不良组NT⁃proBNP、cTnI及CK⁃MB水平均明显高于预后良好组,差异均具有统计学意义(P<0.05)。ROC曲线分析显示,NT⁃proBNP、cTnI、CK⁃MB三者联合检查的AUC更高,为0.931(P<0.05)。结论血清NT⁃proBNP、cTnI及CK⁃MB在急性心梗患者中存在异常表达,可能与急性心梗患者预后密切相关,通过检测上述因子水平有助于评估患者近期预后。

Objective To explore the relationship between serum N terminal brain natriurefic peptide(NT⁃proBNP),cardiac troponin I(cTn I)and creatine kinase⁃MB(CK⁃MB)and the short⁃term prognosis of patients with acute myocardial infarction.Methods The 98 patients with acute myocardial infarction admitted to Beijing Shijitan Hospital,Capital Medical University from January 2019 to January 2021 were selected as the study group.According to whether adverse cardiovascular events of the patients occurred or not during the follow⁃up,they were divided into a poor prognosis group and a good prognosis group.In addition,83 healthy volunteers who had physical examination during the same period were selected as the control group.The serum NT⁃proBNP,cTnI and CK⁃MB levels of different groups were compared,and the values of NT⁃proBNP,cTnI,CK⁃MB and the combined detection of them in predicting the short⁃term prognosis of patients with acute myocardial infarction were analyzed.Results The levels of NT⁃proBNP,cTnI,and CK⁃MB in the study group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).During the follow⁃up period,33 patients had poor prognosis and 65 patients had good prognosis.The levels of NT⁃proBNP,cTnI and CK⁃MB in the poor prognosis group were significantly higher than those in the good prognosis group,and the difference was statistically significant(P<0.05).The results of ROC curve analysis showed that the AUC of the combined examination of NT⁃proBNP,cTnI,and CK⁃MB was higher,which was 0.931.The sensitivity was 87.70%,and the specificity was 81.80%.Conclusion Serum NT⁃proBNP,cTnI and CK⁃MB are abnormally expressed in patients with acute myocardial infarction,which may be closely related to the prognosis of patients with acute myocardial infarction.Detection of the levels of these factors can help to evaluate the short⁃term prognosis of patients.