急性心肌梗死患者血浆和肽素的早期诊断价值探讨  

Changes and significance of plasma and peptide and troponin Ⅰ in patients with acute myocardial infarctio

作　　者：董演 陈占龙[2] 陈梦飞[2] 马育红 张玲[2] 

机构地区：[1]宁夏人民医院急诊科,宁夏银川750002 [2]西北民族大学第一附属医院,宁夏银川750002

出　　处：《宁夏医学杂志》2017年第10期868-869,共2页Ningxia Medical Journal

基　　金：宁夏自然科学基金资助项目(NZ15201)

摘　　要：目的探讨和肽素在急性早期心肌梗死(AMI)患者中的变化特点,为早期诊断AMI提供依据。方法选择收治的急诊持续胸痛4 h内诊断为AMI的患者110例作为AMI组,选取同期胸痛4 h内但经冠状动脉造影术检查未见明显异常者32例为对照组。抽取2组患者胸痛4、6、12、24 h静脉血进行和肽素(Copeptin)与肌钙蛋白Ⅰ(c Tn I)的检测,对比Copeptin与c Tn I的有效性。结果 AMI组4、6、12、24 h的Copeptin及c Tn I水平明显高于对照组(P<0.05),其中Copeptin在AMI患者胸痛4 h内即升高,6 h后逐渐下降;c Tn I在AMI患者胸痛4 h后开始逐渐升高,12 24 h仍有升高趋势;Copeptin ROC曲线下面积(AUG)为0.924,c Tn I AUG为0.812。结论 Copeptin在AMI的早期即开始增高,可作为早期诊断AMI的一种重要心肌坏死标志物。Objective To investigate the changes of serum levels of peptide and troponin in patients with acute myocardial in- farction （AMI）. Methods 110 cases of persistent chest pain within 4 hours and diagnosis of AMI patients were selected as group AMI. 32 cases of persistent chest pain within 4 hours but no abnormality after coronary angiography detection as control group. The pa- tients with 4 h,6 h, 12 h and 24 h the venous blood samples and peptide hormone and troponin I test were selected and compared the ef- fectiveness of copeptin and cardiac troponin I. Results The Copeptin and cTnI level of AMI group 4 h,6 h, 12 h and 24 h were signifi- cantly higher than the control group （ P 〈 0.05 ）. Copeptin increased in chest pain patients with AMI 4h, and then decreased gradually af- ter 6h. cTnI gradually increased in chest pain patients with AMI after 4 h, 12 - 24 h still has a rising trend. The area under the ROC curve of Copeptin （AUG） was 0. 924, cTnI AUG was 0. 812. Conclusion Copeptin is higher in the early stage of AMI, which has a higher diagnostic accuracy than cTnI,and can be used as an important marker for early doagnosis of AMI.

关 键 词：和肽素 肌钙蛋白Ⅰ 急性心肌梗死 诊断 

分 类 号：R542.22[医药卫生—心血管疾病]