摘要
目的:探讨急性心肌梗死患者血浆B型钠尿肽、血浆触珠蛋白的水平变化及临床意义分析。方法:选取2022年1月至2023年12月德驭医疗马鞍山总医院收治的126例急性心肌梗死患者作为研究对象(观察组),同时选取同期进行126例体检的健康者作为对照研究(对照组)。以Gensini评分中位数为界,将冠脉病变程度区分为轻度组和重度组。采用酶联免疫吸附实验分析对照组和观察组以及不同病变程度患者血浆B型钠尿肽、血浆触珠蛋白的变化。相关性分析患者血浆B型钠尿肽、血浆触珠蛋白水平与Gensini评分的相关性。制作受试者工作曲线,分析血清B型钠尿肽、血浆触珠蛋白水平预测心脏不良事件发生的价值。多因素回归分析急性心肌梗死患者冠脉病变程度的影响因素,组间比较采用t检验。结果:对照组志愿者血浆B型钠尿肽和血浆触珠蛋白水平[(19.85±2.14)、(32.54±5.65)ng/L]明显低于观察组[(421.89±50.25)、(169.85±20.47)ng/L],差异有统计学意义(t=15.892、10.449,P<0.05)。轻度组急性心肌梗死患者血浆B型钠尿肽和血浆触珠蛋白水平[(324.78±42.65)、(125.98±15.44)ng/L]明显低于重度组[(451.52±21.22)、(175.14±24.33)ng/L],差异有统计学意义(t=15.892、10.449,P<0.05)。轻度组患者Gensini评分[(65.78±8.95)分]明显低于重度组患者[(91.22±12.48)分],差异有统计学意义(t=15.892,P<0.05)。急性心肌梗死患者血浆B型钠尿肽和血浆触珠蛋白与Gensini评分呈正相关(r=0.512,P<0.05)。Logisitic回归分析显示,高血压史、高血脂史、心肌肌钙蛋白Ⅰ、血浆B型钠尿肽和血浆触珠蛋白是急性心肌梗死患者冠脉病变进展的危险因素[比值比(OR)=2.145、3.516、4.521、2.981、3.012,P<0.05]。心脏不良事件组患者血浆B型钠尿肽和血浆触珠蛋白水平[(473.88±17.89)、(180.47±23.54)ng/L]明显高于非心脏不良事件组患者[(401.52±17.65)、(152.96±19.58)ng/L],差异有统计学意义(t=19.687、15.441,P<0.05)。结论:急性心肌梗死患者血浆B型钠尿肽、血浆触珠蛋白水平显著增加,与冠脉病变程度相关,对心脏不良事件有预测价值。
Objective:To investigate the changes of plasma B-type natriuretic peptide and plasma haptoglobin in patients with acute myocardial infarction(AMI)and their clinical significance.Methods:126 patients with acute myocardial infarction admitted to Deyu medical ma’anshan general hospital from January 2022 to December 2023 were selected as the study object(observation group),and healthy subjects who underwent physical examination during the same period were selected as the control group(control group).The median Gensini score was used to divide the degree of coronary lesions into mild and severe groups.Enzyme-linked immunosorbent assay was used to analyze the changes of serum B-type natriuretic peptide and plasma haptoglobin in control group,observation group and patients with different pathological degree.The correlation between Gensini score and serum B-type natriuretic peptide and plasma haptoglobin level was analyzed.The value of serum B type natriuretic peptide and plasma haptoglobin levels in predicting cardiac adverse events was analyzed.Multivariate regression analysis of the factors affecting the degree of coronary artery lesion in patients with acute myocardial infarction,t-test was used for comparison between groups.Results:The levels of plasma B-type natriuretic peptide and plasma haptoglobin in control group[(19.85±2.14),(32.54±5.65)ng/L]were significantly lower than those in observation group[(421.89±50.25),(169.85±20.47)ng/L,t=15.892,10.449,P<0.05].The levels of plasma B-type natriuretic peptide and plasmoglobin[(324.78±42.65),(125.98±15.44)ng/L]in mild group were significantly lower than those in severe groups[(451.52±21.22),(175.14±24.33)ng/L,t=15.892,10.449,P<0.05].The Gensini score of mild group[(65.78±8.95)points]was significantly lower than that of severe group[(91.22±12.48)points,t=15.892,P<0.05].Gensini scores were significantly correlated with B-type natriuretic peptide and plasmoglobin in patients with acute myocardial infarction(r=0.512,P<0.05).Logisitic regression analysis shows that the history of history of hypertension,hyperlipidemia,and myocardial troponin I,plasma b-type natriuretic peptide and touch the globin plasma is a risk factor for coronary artery lesions in patients with acute myocardial infarction,progress[odds ratio(OR)=2.145,3.516,4.521,2.981,3.012,P<0.05].Plasma B-type natriuretic peptide and plasma haptoglobin levels[(473.88±17.89),(180.47±23.54)ng/L]in patients with adverse cardiac events were significantly higher than those in patients without adverse cardiac events[(401.52±17.65),(152.96±19.58)ng/L],the difference was statistically significant(t=19.687,15.441,P<0.05).Conclusion:The levels of plasma B-type natriuretic peptide and plasmoglobin increased significantly in patients with acute myocardial infarction,which correlated with the degree of coronary artery disease and had predictive value for cardiac adverse events.
作者
周丽红
马继民
叶方
薛倩
Zhou Lihong;Ma Jimin;Ye Fang;Xue Qian(Emergency Center of DeYu Medical Ma'anshan General Hospital,Ma'anshan 243000,China;Intensive Care Unit of DeYu Medical Ma'anshan General Hospital,Ma'anshan 243000,China)
出处
《中华实验外科杂志》
CAS
2024年第10期2349-2352,共4页
Chinese Journal of Experimental Surgery
基金
2021年度安徽省卫生健康科研项目(AHWJ2021a039)。
关键词
急性心肌梗死
B型钠尿肽
触珠蛋白
心脏不良事件
Acute myocardial infarction
B type natriuretic peptide
Haptoglobin
Major adversecardiac events
