和肽素联合肌钙蛋白I评估老年急性心肌梗死患者预后的价值  

The value of copeptin combined with troponin I in assessing the prognosis of elderly patients with acute myocardial infarction

作　　者：温伟[1] 文力[1] 安稳 全锦花[1] 张新超[1] Wen Wei;Wen Li;An Wen;Quan Jinhua;Zhang Xinchao(Department of Emergency Medicine»Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine»Chinese Academy of Medical Sciences,Beijing 100730,China;Southern District Geriatrics Department ythe Second Hospital of Shandong University,Jinan 250002,China)

机构地区：[1]北京医院急诊科国家老年医学中心,中国医学科学院老年医学研究院,100730 [2]山东大学第二医院南部院区老年医学科,济南250033

出　　处：《中华老年医学杂志》2022年第2期135-138,共4页Chinese Journal of Geriatrics

基　　金：卫生行业科研专项基金(201002011)。

摘　　要：目的研究和肽素(COP)及肌钙蛋白I(cTnI)对老年急性心肌梗死(AMI)患者预后评估的价值。方法纳入北京医院急诊科2016年8月至2018年8月收治的81例老年AMI患者作为研究对象,收集来诊首次血清标本,测定COP和cTnI并完善其他相关检查,随访6个月评估各因素与死亡风险的关联程度,并比较各指标对预后的评估价值。结果生存组与死亡组比较,COP、cTnI、动脉血乳酸(LAC)、急性生理与慢性健康(APACHEⅡ)评分、D-二聚体(D-Dimer)、N-末端脑钠肽前体(NT-proBNP)的差异均有统计学意义(均P<0.05)。死亡组COP及cTnI水平明显高于生存组[COP:29.08(13.73,43.19)ng/L比13.76(4.81,20.82)ng/L;cTnI:0.78(0.35,2.23)μg/L比0.33(0.19,0.57)μg/L]。二分类Logistic回归分析结果显示,COP(OR=1.071、95%CI:1.016~1.130、P=0.040)和cTnI(OR=3.261、95%CI:1.058~10.045、P=0.011)是老年AMI患者6个月死亡的独立危险因素。将cTnI、COP以及两者联合分别描绘ROC曲线,计算AUC分别为0.742(0.593~0.892)、0.752(0.655~0.910)、0.790(0.648~0.932)。结论血清COP及cTnI水平可用于评估老年AMI患者预后,两者联合应用对近期死亡风险的预测能力有提升趋势。Objective To investigate the prognostic value of copeptin(COP)and troponin I(cTn1)for elderly patients with acute myocardial infarction(AMI).Methods 81 elderly AMIpatients admitted to the Department of Emergency of Beijing Hospital from August 2016 to August2018 were included as study subjects.COP and cTnl were measured and other relevant examinationswere conducted.The correlation between each factor and the risk of death was evaluated in a 6-monthfollow-up,and the prognostic value of each indicator was assessed.Results There were statisticallysignificant differences in COP,cTn1,arterial lactic acid(LAC),the acute physiology and chronic healthevaluation(APACHE)Ⅱscore,D-Dimer and N-terminal brain natriuretic peptide precursor(NT-pro-BNP)between the survival group and the death group(all P<0.05).COP and cTnl levels in the deathgroup were significantly higher than those in the survival group[COP:29.08(13.73,43.19)ng/Lus.13.76(4.81,20.82)ng/L;cTnI:0.78(0.35,2.23)μg/L us.0.33(0.19,0.57)μg/L].BinaryLogistic regression analysis showed that COP(OR=1.071,95%CI;1.016-1.130,P=0.040)and cTnl(OR=3.261,95%CI:1.058-10.045,P=0.011)were independent risk factors for death within 6months in elderly AMI patients.The ROC curves were constructed for cTnI,COP and theircombination,and the AUCs(95%CI)were 0.742(0.593-0.892),0.752(0.655-0.910)and 0.790(0.648-0.932),respectively.Conclusions COP and cTnI may be used to assess the prognosis forelderly patients with AMI,and their combination can further increase the predictive value for short-term death risk.

关 键 词：心肌梗死 肌钙蛋白I 和肽素 预后 

分 类 号：R542.22[医药卫生—心血管疾病]