血清Hcy与NT-proBNP和hs-CRP水平与急性心肌梗死患者心功能及预后的相关性

Correlation of serum Hcy and NT-proBNP and hs-CRP levels with cardiac function and prognosis in patients with acute myocardial infarction

目的探讨血清同型半胱氨酸(HCY)、N末端B型脑钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)水平与急性心肌梗死患者心功能及预后的相关性,以期为临床早期制定干预方案提供参考。方法选取86例开封市人民医院2021年4月—2023年4月就诊的急性心肌梗死患者,比较不同心功能分级患者血清Hcy、NT-proBNP、hs-CRP水平及心功能指标[左心室舒张末内径(LVDD)、左室射血分数(LVEF)],分析血清Hcy、NT-proBNP、hs-CRP水平与急性心肌梗死患者心功能的相关性,并比较不同预后患者血清Hcy、NT-proBNP、hs-CRP水平,并分析其与急性心肌梗死患者预后的关系。结果不同心功能分级患者入院时血清Hcy、NT-proBNP、hs-CRP水平及LVDD比较:Ⅳ级>Ⅲ级>Ⅱ级,LVEF比较:Ⅳ级<Ⅲ级<Ⅱ级(P<0.05);血清Hcy、NT-proBNP、hs-CRP与心功能分级、LVDD呈正相关,与LVEF呈负相关(P<0.05);与预后良好患者比较,预后不良患者入院时血清Hcy、NT-proBNP、hs-CRP水平较高(P<0.05);经logistic回归方程分析结果显示,血清Hcy、NT-proBNP、hs-CRP为急性心肌梗死患者预后的影响因素(P<0.05)。结论血清Hcy、NT-proBNP、hs-CRP水平与急性心肌梗死患者心功能及预后具有显著相关性,为临床早期评估患者预后,针对性制定干预方案提供参考。

Objective To investigate the correlation between serum homocysteine(HCY),N-terminal pro-B-type natriuretic peptide(NT-proBNP)and hypersensitive C-reactive protein(hs-CRP)levels and cardiac function and prognosis in patients with acute myocardial infarction,so as to provide reference for early clinical intervention.Methods A total of 86 patients with acute myocardial infarction in Kaifeng People's Hospital from April 2021 to April 2023 were selected,and the serum levels of Hcy,NT-proBNP,hs-CRP and cardiac function indexes[left ventricular end-diastolic diameter(LVDD),left ventricular ejection fraction(LVEF)]of patients with different cardiac function grades were compared.The correlation between serum Hcy,NT-proBNP and hs-CRP levels and cardiac function in patients with acute myocardial infarction was analyzed,the serum Hcy,NT-proBNP and hs-CRP levels in patients with different prognosis were compared,and the relationship between them and the prognosis of patients with acute myocardial infarction was analyzed.Results The levels of serum Hcy,NT-proBNP,hs-CRP and LVDD were compared in patients with different cardiac function grades at admission:Grade Ⅳ>Grade Ⅲ>Grade Ⅱ,and LVEF was compared in grade Ⅳ<Grade Ⅲ<Grade Ⅱ(P<0.05).Serum Hcy,NT-proBNP and hs-CRP were positively correlated with cardiac function grade and LVDD,but negatively correlated with LVEF(P<0.05).Compared with the patients with good prognosis,the serum levels of Hcy,NT-proBNP and hs-CRP were higher in the patients with poor prognosis at admission(P<0.05).Logistic regression equation analysis showed that serum Hcy,NT-proBNP and hs-CRP were the prognostic factors of patients with acute myocardial infarction(P<0.05).Conclusion Serum Hcy,NT-proBNP and hs-CRP levels are significantly correlated with cardiac function and prognosis in patients with acute myocardial infarction,which provides reference for early clinical assessment of patient prognosis and targeted intervention.