摘要
目的:探讨血清和肽素对急性心肌梗死(AMI)早期诊断及预后判断的价值。方法:选择因胸痛就诊且明确诊断为AMI的患者92例(AMI组),分别检测胸痛发作3h内及胸痛发作6、12和24h后血清和肽素、超敏肌钙蛋白T(hs-TnT)水平,并随访1年内主要心血管不良事件(MACE)的发生情况。另选择同期健康体检者60例作为对照组。结果:AMI组胸痛发作3h内血清和肽素水平较对照组明显升高[(1.00±0.45)ng/ml∶(0.37±0.62)ng/ml,P<0.01],此时hs-TnT水平与对照组比较差异无统计学意义(P=0.553)。AMI组胸痛发作6、12h后血清和肽素水平较对照组明显升高[(0.64±0.39)ng/ml∶(0.37±0.62)ng/ml、(0.89±0.45)ng/ml∶(0.37±0.62)ng/ml,均P<0.01],此时hs-TnT水平亦较对照组明显升高[(0.81±1.07)ng/ml∶0.014ng/ml、(0.74±0.82)ng/ml∶0.014ng/ml,均P<0.01]。和肽素诊断AMI的ROC曲线下面积为0.900,优于hs-TnT的0.854(P<0.01)。随访12个月,AMI组8例发生MACE,且发生MACE者在胸痛发作24h后血清和肽素水平比未发生MACE者明显升高[(0.91±0.49)ng/ml∶(0.39±0.13)ng/ml,P<0.01]。结论:血清和肽素水平对AMI的早期诊断(胸痛3h内)有较好的敏感性,胸痛发作24h后和肽素水平持续升高提示预后不佳。
Objective：To investigate the value of serum copeptin in the early diagnosis and short-term prognosis of acute myocardial infarction （AMI）. Method：Ninety-two AMI patients with chest pain were recruited. The ser-um levels of copeptin and high sensitiviw troponin T （hs-TnT） were detected in all patients within 3 h, 6 h, 12 h, and 24 h after onset of the chest pain. The major adverse cardiovascular events （MACE） were recorded during the follow-up of 12 months. Result： The eopeptin level in AMI patients within 3 hours after the onset of pain was sig- nificantly higher than that in the normal control （P〈0.01）, but there was no significant difference in hs-TnT （P=0. 553）. The levels of serum copeptin and hs TnT in AMI patients within 6 h or t2 h after the onset of pain were both higher than those in the normal control （P〈0.01）. The area under ROC curve of copeptin in diagnosis of AMIwas better than hs-TnT （0.900 vs 0.854, P〈0.01）. During the follow-up of 12 months, 8 cases occurred MACE in AMI group, whose copeptin levels within 24 h after the onset of chest pain was significantly higher than those without MACE （P〈0.01）. Conclusion：Copeptin has a good sensitivity in the early diagnosis of AMI, and it can be used to assess the prognosis of AMI. Copeptin continuous rise indicates poor prognosis.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2013年第5期367-370,共4页
Journal of Clinical Cardiology
关键词
急性心肌梗死
和肽素
早期诊断
预后
acute myocardial infarction
copeptin
early diagnosis
prognosis
