床旁快速血液分析联合检测心肌损伤标志物预警改善ACS患者预后状况的临床研究  

A clinical study of bedside rapid blood analysis combined with detection of myocardial injury markers for improving the prognosis of patients with ACS

作　　者：陈芬芬 俞春梅 杨娇娇[1] 宗春燕 CHEN Fenfen;YU Chunmei;YANG Jiaojiao;ZONG Chunyan(Department of Emergency,Nantong First People's Hospital,Nantong 226001,China)

机构地区：[1]南通市第一人民医院急诊科,江苏南通226001

出　　处：《中国急救复苏与灾害医学杂志》2020年第12期1371-1374,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：南通市卫生和计划生育委员会科研课题(编号:WKZL2018024)。

摘　　要：目的针对床旁快速联合检测心肌损伤标志物预警改善ACS患者预后状况的关系进行分析。方法入选2015年5月—2019年2月于南通市第一人民医院住院并确诊ACS的患者145例为病例组,其中男82例,女63例,年龄(66.3±11.3)岁。同期选取本院门诊就诊的非ACS者作为对照组。病例组按照IMA、NT-proBNP和TnI-Ultra水平的均值进行分组,对比观察两组患者心电图、冠状造影以及术后心脏彩超等情况,同时对比观察两组患者住院及随访并发症情况。以探讨IMA、NT-proBNP和TnI-Ultra水平与心电图、冠脉造影及术后心脏彩超情况的关联性。结果病例组IMA、NT-proBNP和TnI-Ultra均显著高于对照组,差异有统计学意义(P<0.05)。低IMA、NT-proBNP和TnI-Ultra组以及未应用床旁快速血液分析组ST段回落率、术后达TIMI 3级人数、LVEF、Gensini评分、术后1年LVEF水平均显著高于高IMA组(P<0.05),而门球时间、病变血管数目、室壁瘤直径以及术后1年LVEDD均显著低于高IMA组(P<0.05)。结论床旁快速血液分析联合检测心肌损伤标志物能较好的监测ACS患者预后状况,值得临床推广。Objective To investigate the analyze the relationship between rapid detection of myocardial injury markers and improvement of prognosis in patients with acute coronary syndromes,ACS ACS.Methods Peripheral venous blood samples were collected from 145 patients with ACS,82 males and 63 females,aged(66.3±11.3).immediately after they were admitted to undergo examination of NT-proBNP by colorimetric method,and of TnI-Ultra and IMA by immunosuppression.The patients were followed up 1,3,6,9,and 12 months later by telephone survey or putpatient department visit to record the major adverse cardiovascular events(MACE).Non-ACS patients who were admitted to the outpatient clinic of the hospital were selected as the control group.The case group was divided according to the mean values of IMA,NT-proBNP and TnI-Ultra levels.The electrocardiogram,coronary angiography and postoperative cardiac ultrasound were compared between the two groups.The complications of hospitalization and follow-up were compared between the two groups.To investigate the correlation between IMA,NT-proBNP and TnI-Ultra levels and electrocardiogram,coronary angiography and postoperative cardiac ultrasound.Results The IMA,NT-proBNP and TnI-Ultra in the case group were significantly higher than the control group,and the difference was statistically significant(P<0.05).The low IMA,NT-proBNP,and TnI-Ultra groups,as well as the ST-segment fall rate in the bedside rapid blood analysis group,the number of TIMI 3 patients after surgery,the LVEF,the Gensini score,and the LVEF level after 1 year were significantly higher than the high IMA.The group(P<0.05),and the croquet time,the number of diseased vessels,the diameter of the aneurysm and the LVEDD after 1 year were significantly lower than the high IMA group(P<0.05).Conclu⁃sion Bedside rapid blood analysis combined with detection of myocardial injury markers can better monitor the prognosis of patients with ACS,which is worthy of clinical promotion.

关 键 词：床旁快速血液分析 心肌损伤标志物 ACS 预后 

分 类 号：R44[医药卫生—诊断学]