血清Hcy、cTnT、甲状腺激素水平对急性心肌梗死病情严重程度及预后评估的价值  

Value of serum Hcy,cTnT and thyroid hormone levels in severity and prognosis evaluation of acute myocardial infarction

作　　者：骆金轮 吴非 张登洪[2] 祝东强[3] 洪刚 LUO Jin-lun;WU Fei;ZHANG Deng-hong(Emergency Medicine Department,Chengdu Fifth People's Hos-pital,Chengdu 611130,China)

机构地区：[1]成都市第五人民医院急诊医学科,四川成都611130 [2]成都市第五人民医院心内科,四川成都611130 [3]成都市第五人民医院普外科,四川成都611130

出　　处：《中国实验诊断学》2021年第4期490-493,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的分析血清同型半胱氨酸(Hcy)、肌钙蛋白T(cTnT)、甲状腺激素水平对急性心肌梗死(AMI)病情及预后评估的价值。方法2018年1月-2020年1月在成都市第五人民医院诊治的AMI、UA及冠脉狭窄程度<50%患者分别纳入AMI组(n=61)、UA组(n=30)、对照组(n=30)。比较三组一般资料、血清Hcy、cTnT、甲状腺激素水平;不同病情、预后的AMI患者血清Hcy、cTnT、甲状腺激素的评估价值。结果AMI组Hcy、cTnT、促甲状腺激素(TSH)高于对照组,游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)低于UA组及对照组(P<0.05);Gensini积分>40分患者Hcy、cTnT及TSH水平高于Gensini积分≤40分患者,FT3、FT4显著低于Gensini积分≤40分患者(P<0.05);死亡组Hcy、cTnT及TSH高于存活组,FT3、FT4低于存活组(P<0.05);cTnT预测AMI病情的曲线下面积值(AUC)值最高,敏感度、特异度为78.26%、93.33%;FT3预测AMI预后的AUC最高,敏感度、特异度为80.00%、88.24%。结论血清Hcy、cTnT、甲状腺激素水平可作为临床早期评估AMI患者病情严重程度及预后的敏感指标。Objective To analyze the value of serum homocysteine(Hcy),troponin T(cTnT)and thyroid hormone levels in condition and prognosis evaluation of acute myocardial infarction(AMI).Methods Between January 2018 and January 2020,patients with AMI(n=61),unstable angina(UA)(UA group),and coronary artery stenosis<50%(control group)were enrolled in this study.General data,serum Hcy,cTnT and thyroid hormone levels in the 3 group were compared.Serum Hcy,cTnT and thyroid hormone levels in AMI patients in different conditions and with different prognosis,and their value in condition and prognosis evaluation of AMI patients were analyzed.Results Hcy,cTnT and thyroid-stimulating hormone(TSH)in AMI group were higher,while free triiodothyronine(FT3)and free thyroxine(FT4)were lower than those in UA group and the control group(P<0.05).Hcy,cTnT and TSH levels were higher,while FT3 and FT4 were lower in patients with Gensini scores>40 than those with Gensini scores≤40(P<0.05).Hcy,cTnT and TSH in death group were higher,and FT3 and FT4 were lower than those in survival group(P<0.05).The area under the curve(AUC)of CTnT for predicting the severity of AMI was the largest,and its sensitivity and specificity were 78.26%and 93.33%.The AUC of FT3 for predicting the prognosis of AMI was the largest,and its sensitivity and specificity were 80.00%and 88.24%.Conclusion Serum Hcy,cTnT and thyroid hormone levels can be used as sensitive indicators for early clinical severity and prognosis assessment of patients with AMI.

关 键 词：血清同型半胱氨酸 肌钙蛋白T 甲状腺激素 急性心肌梗死 病情 预后 

分 类 号：R542.22[医药卫生—心血管疾病]