同型半胱氨酸、降钙素原、心肌肌钙蛋白T、甲状腺激素水平检测在急性心肌梗死中的应用

Application of Tests of Homocysteine,Procalcitonin,Cardiac Troponin T(cTnT)and Thyroid Hormone Levels in Acute Myocardial Infarction

目的:探讨血清同型半胱氨酸(Hcy)、降钙素原(PCT)、心肌肌钙蛋白T(cTnT)及甲状腺激素水平检测对急性心肌梗死(AMI)患者病情、炎性反应程度及预后效果的临床应用价值。方法:选取2018年6月-2021年6月江门市新会区司前人民医院收治的AMI患者80例为观察组,选取2020年6月-2021年6月于江门市新会区司前人民医院体检的健康者50例为对照组。使用冠脉Gensini评分评估病情程度,随访6个月,检测与比较观察组与对照组、Gensini>40分与Gensini≤40分患者、预后不良与预后良好患者的Hcy、PCT、cTnT及促甲状腺激素(TSH)、游离三碘甲状腺素(FT_(3))、游离甲状腺激素(FT_(4))水平。结果:观察组Hcy、PCT、cTnT、TSH水平高于对照组,FT_(3)、FT_(4)水平低于对照组,差异有统计学意义(P<0.05);Gensini>40分组Hcy、PCT、cTnT及TSH水平高于Gensini≤40分组,FT_(3)、FT_(4)水平则低于Gensini≤40分组,差异有统计学意义(P<0.05);预后不良组Hcy、PCT、cTnT及TSH水平高于预后良好组,FT3、FT4水平低于预后良好组,差异有统计学意义(P<0.05)。结论:检验Hcy、cTnT、PCT及甲状腺激素水平可有效了解AMI患者机体炎性反应水平并反映病情状态,对预后评估也有一定参考价值。

Objective:To explore the clinical application value of tests of serum homocysteine(Hcy),procalcitonin(PCT),cardiac troponin T(cTnT)and thyroid hormone levels in the severity,inflammatory reaction and prognosis of patients with acute myocardial infarction(AMI).Methods:Eighty AMI patients admitted to Siqian People's Hospital of Xinhui District of Jiangmen City from June 2018 to June 2021 were selected as the observation group,and 50 healthy people who underwent physical examination in Siqian People's Hospital of Xinhui District of Jiangmen City from June 2020 to June 2021 were selected as the control group.The severity of disease was assessed using coronary Gensini scores.The subjects were followed up for 6 months.The levels of Hcy,PCT,cTnT,and thyroid-stimulating hormone(TSH),free triiodothyroxine(FT3),free thyroid hormone(FT4)in the observation group and control group,in patients with Gensini score of>40 points and≤40 points,in patients with poor prognosis and good prognosis were detected and compared.Results:The levels of Hcy,PCT,cTnT and TSH in the observation group were higher than those in the control group,and the levels of FT_(3) and FT_(4) were lower than those in the control group,and the difference was statistically significant(P<0.05).The levels of Hcy,PCT,cTnT and TSH in the Gensini score of>40 points group were higher than those in the Gensini score of≤40 points group,and the levels of FT3 and FT4 were lower than those in the Gensini score of≤40 points group,and the difference was statistically significant(P<0.05).The levels of Hcy,PCT,cTnT and TSH in the poor prognostic group were higher than those in the good prognosis group,and the levels of FT_(3) and FT_(4) were lower than those in the good prognosis group,and the difference was statistically significant(P<0.05).Conclusion:Tests of Hcy,cTnT,PCT and thyroid hormone levels can effectively understand the level of inflammatory reaction in patients with AMI and reflect the state of the disease,and has certain reference value for prognosis evaluation.