血清Nesfatin-1、NT-proBNP、CysC与STEMI患者心肌酶和心功能的相关性  

Correlation between serum Nesfatin-1,N-terminal pro-brain natriuretic peptide,and cystatin C levels and myocardial enzymes and cardiac function in patients with ST-elevation myocardial infarction

作　　者：罗伟俊[1] 陈东海[1] 吴仙军[1] Luo Weijun;Chen Donghai;Wu Xianjun(Department of Cardiology,Lishui People's Hospital,Lishui 323000,Zhejiang Province,China)

机构地区：[1]丽水市人民医院心血管内科,丽水323000

出　　处：《中国基层医药》2024年第2期170-174,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨血清摄食抑制因子1(Nesfatin-1)、N末端脑钠肽前体(NT-proBNP)、胱抑素C(CysC)与急性ST段抬高型心肌梗死(STEMI)患者心肌酶和心功能的相关性。方法采用病例对照研究,选取丽水市人民医院2020年1月至2022年12月收治的急性STEMI患者100例为STEMI组,另选取该院2020年1月至2022年12月健康体检者80例为对照组。检测两组血清Nesfatin-1、NT-proBNP、CysC及肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI),采用彩色多普勒超声测定两组左室射血分数(LVEF)、左室舒张末期内径(LVDD)和左室收缩末期内径(LVDS),并进行相关性分析。结果STEMI组血清Nesfatin-1[(89.96±15.25)ng/L]低于对照组[(226.36±37.47)ng/L],而NT-proBNP[(1325.12±378.48)ng/L]和CysC[(1.37±0.24)mg/L]均高于对照组[(78.95±13.42)ng/L和(0.79±0.16)mg/L],差异均有统计学意义(t=33.15、-29.42、-18.56,均P<0.001)。STEMI组CK-MB[(46.51±12.14)U/L]和cTnI[(1.13±0.25)U/L]均高于对照组[(12.23±4.01)U/L和(0.09±0.02)U/L],差异均有统计学意义(t=-24.06、-37.09,均P<0.001)。STEMI组LVEF[(37.84±5.45)%]低于对照组[(72.41±4.26)%],而LVDD[(40.92±5.25)mm]和LVDS[(58.98±6.25)mm]均高于对照组[(19.86±3.36)mm和(34.21±4.38)mm],差异均有统计学意义(t=46.49、-31.13、-30.03,均P<0.001)。血清Nesfatin-1与LVEF呈正相关(r=0.572),而与CK-MB、cTnI、LVDD和LVDS均呈负相关(r=-0.498、-0.617、-0.506、-0.534,均P<0.05);NT-proBNP和CysC与LVEF呈负相关(r=-0.653、-0.607),而与CK-MB、cTnI、LVDD和LVDS均呈正相关(r=0.582、0.526、0.712、0.565,0.631、0.578、0.659、0.635,均P<0.05)。结论急性STEMI患者血清Nesfatin-1水平降低,而NT-proBNP和CysC水平升高,且Nesfatin-1、NT-proBNP、CysC与心肌酶和心功能密切相关。Objective To correlate serum Nesfatin-1,N-terminal pro-brain natriuretic peptide(NT-proBNP),and cystatin C(CysC)levels with myocardial enzymes and cardiac function in patients with acute ST-elevation myocardial infarction(STEMI).Methods This is a case-control study.A total of 100 patients with acute STEMI who received treatment at Lishui People's Hospital from January 2020 to December 2022 were included in the STEMI group.An additional 80 healthy controls who concurrently received physical examinations in the same hospital were included in the control group.Serum levels of Nesfatin-1,NT-proBNP,CysC,creatine kinase-MB(CK-MB),and cardiac troponin I(cTnI)levels were determined in each group.Left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVDD),and left ventricular end-systolic diameter(LVDS)were measured using color Doppler ultrasound.Correlation analysis was performed.Results Serum Nesfatin-1 level in the STEMI group was(89.96±15.25)ng/L,which was significantly lower than(226.36±37.47)ng/L in the control group(t=33.15,P<0.05).Serum levels of NT-proBNP and CysC in the STEMI group were(1325.12±378.48)ng/L and(1.37±0.24)mg/L,which were significantly higher than(78.95±13.42)ng/L and(0.79±0.16)mg/L in the control group(t=-29.42,-18.56,both P<0.05).Serum CK-MB and cTnI levels in the STEMI group were(46.51±12.14)U/L and(1.13±0.25)U/L,respectively,which were significantly higher than(12.23±4.01)U/L and(0.09±0.02)U/L in the control group(t=-24.06,-37.09,both P<0.05).The LVEF in the STEMI group was(37.84±5.45)%,which was significantly lower than(72.41±4.26)%in the control group(t=46.49,P<0.05).The LVDD and LVDS in the STEMI group were(40.92±5.25)mm and(58.98±6.25)mm,which were significantly higher than(19.86±3.36)mm and(34.21±4.38)mm in the control group(t=-31.13,-30.03,both P<0.05).Serum Nesfatin-1 level was positively correlated with LVEF(r=0.572),but it was negatively correlated with serum CK-MB and cTnI levels,LVDD,and LVDS(r=-0.498,-0.617,-0.506,-0.534,all P<0.05).Serum N

关 键 词：ST段抬高型心肌梗死 利钠肽 脑 肌酸激酶 MB型 肌钙蛋白 心脏功能试验 超声检查 多普勒 彩色 摄食抑制因子1 胱抑素C 

分 类 号：R542.22[医药卫生—心血管疾病]