高敏肌钙蛋白T与ST段抬高型急性心肌梗死患者入院早期血清因子和心脏结构功能的相关性研究  

Study on correlations among serum factors,cardiac structure and function and Hs-cTnT of STEMI patients

作　　者：靳绵绵 靳思思[1] 

机构地区：[1]焦作市第二人民医院,河南焦作454000

出　　处：《中国民康医学》2017年第15期1-4,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨高敏肌钙蛋白T(High Sensitivity Cardiac Troponin,hs-cTnT)与ST段抬高型急性心肌梗死(ST elevation myocardial infarction,STEMI)患者入院早期血清因子和心脏结构功能的相关性。方法:选取STEMI患者180例,根据入院早期的hs-cTnT水平分为低值组(≤0.009 ng/ml)、中值组(0.010~0.017 ng/ml)和高值组(≥0.018 ng/ml),其中低值组72例、中值组58例、高值组50例。比较三组患者的血清因子高敏C反应蛋白(High-sensitivity C-reactive protein,hs-CRP)、脑钠肽(Brain natriuretic peptide,BNP)、肌酸激酶同工酶(Creatine kinase-MB,CK-MB)、血管性假血友病因子(Von willebrand factor,vWF)和内皮素1(Endothelin-1,ET-1)水平,以及心脏结构功能指标左心室舒张末内径(Left ventricular end dilated diameter,LVEDD)、左心室收缩末内径(Left ventricular end systolic diameter,LVEDS)、左心房前后径(Left atrium diameter,LAD)、室间隔厚度(Interventricular septal,IVSd)、左心室后壁厚度(Left ventricular posterior wall diameter,LVPWD)、左心室射血分数(Left ventricular ejection,LVEF)以及左室质量指数(Left ventricular mass index,LVMI)的差异。并采用Spearman相关性分析及Logistic回归模型用于分析hs-cTnT与其他血清因子和心脏结构功能的相关性。结果:与Hs-cTnT低值组和中值组相比,高值组患者的hs-CRP、BNP、CK-MB、vWF和ET-1水平均显著提升,LAD、LVEDD、LVEDS、IVSd、LVPWD、LVMI均显著增大或增厚,而LVEF则显著下降,差异具有统计学意义(P<0.05)。相关分析结果显示,Hs-cTnT水平与血清因子和LAD、LVEDD、LVEDS、IVSd、LVPWD、LVMI呈现正相关,与LVEF呈现负相关(P<0.05)。结论:Hs-cTnT水平与STEMI患者入院早期的血清因子和心脏结构功能存在相关性。Objective： To explore correlations among serum factors,cardiac structure and function and hs-cTnT（ high sensitivity cardiac troponin T） of STEMI（ ST elevation myocardial infarction） patients. Methods： A total 180 STEMI patients were recruited in this study,and divided into low level group（ ≤0.009 ng/ml,72 cases）,medial level group（ 0.010-0.017 ng/ml,58 cases）and low level group（ ≥0.018 ng/ml,50 cases） according to the level of hs-cTnT. The levels of serum factors of hs-CRP（ high-sensitivity C-reactive protein）,BNP（ brain natriuretic peptide）,CK-MB（ creatine kinase-MB）,vWF（ von willebrand factor）,ET-1（ endothelin-1）,and the cardiac structure and function LVEDD（ left ventricular end dilated diameter）,LVESD（ left ventricular end systolic diameter）,LAD（ left atrium diameter）,IVSd（ interventricular septa）,LVPWD（ left ventricular posterior wall diameter）,LVEF（ left ventricular ejection） and LVMI（ left ventricular mass index） were compared among the three groups. The Spearman analysis and Logistic regression model were used to evaluate the correlations among rhe serum factors,cardiac structure,function and hscTnT level. Results： Compared with the low and media level groups,the levels of hs-CRP,BNP,CK-MB,vWF,ET-1,LVEDD,LVESD,LAD,IVSd,LVPWD and LVMI were significant higher,while the LVEF were significant lower,and the differences were statistically signiicnat（ P〈0.05）. The correlation analysis showed that the level of hs-cTnT was positively correlated with the serum factors and LVEDD,LVESD,LAD,IVSd,LVPWD,and LVMI,while it was negatively correlated with LVEF（ P〈0.05）. Conclusions：The level of hs-cTnT is correlated with the early serum factors,cardiac structure and function of the STEMI patients.

关 键 词：高敏肌钙蛋白T ST段抬高型急性心肌梗死 血清因子 心脏结构功能 

分 类 号：R542.22[医药卫生—心血管疾病]