血清cTnI、Myo、CK-MB结合临床特征在急性心梗患者PCI术预后评估中的应用价值分析  

Analysis of application value of serum cTnI,Myo,and CK-MB combined with clinical features in prognostic assessment of acute myocardial infarction patients undergoing PCI

作　　者：李保珍 曹磊 郑德伟 张海峰 LI Bao-zhen;CAO Lei;ZHENG De-wei(Intensive Care Unit,Yantai Yeda Hospital,Yantai 264000,China)

机构地区：[1]烟台业达医院重症医学科,264000 [2]烟台业达医院心内科,264000

出　　处：《中国实用医药》2025年第7期38-41,共4页China Practical Medicine

摘　　要：目的分析血清心肌肌钙蛋白I(cTnI)、肌红蛋白(Myo)、肌酸激酶同工酶(CK-MB)结合临床特征在急性心肌梗死(心梗)(AMI)患者经皮冠状动脉介入(PCI)术预后评估中的应用价值。方法回顾性分析接受PCI术治疗入住重症加强护理病房(ICU)的100例AMI患者的临床资料,并对患者展开为期3个月的随访调查,依据随访结果将患者分为预后良好组(69例)和预后不良组(31例)。收集患者的性别、年龄、吸烟史、高血压病史、糖尿病病史、高脂血症病史、胸痛时间、入住ICU时间、血管活性药物使用情况、心功能Killip分级、置入支架数量、支架长度、支架内径、支架部位、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血糖(Glu)、乳酸(Lac)、cTnI、Myo、CK-MB、脑利钠肽(BNP)、射血分数(EF)。采用多因素Logistic回归分析AMI患者PCI术预后不良的影响因素。结果单因素分析显示:预后不良组cTnI(337.66±245.40)pg/ml、Myo(969.53±604.58)ng/ml、CK-MB(115.73±75.84)U/L、BNP(6225.09±5960.66)pg/ml、Lac(3.51±2.64)mmol/L及心功能Killip分级(2.77±1.17)级高于预后良好组的(218.99±161.20)pg/ml、(438.99±367.11)ng/ml、(62.57±61.27)U/L、(2928.23±2332.67)pg/ml、(2.18±1.20)mmol/L、(1.36±0.86)级,血管活性药物使用率12.9%(4/31)、EF(51.65±9.84)%低于预后良好组的63.8%(44/69)、(60.83±7.50)%,入住ICU时间(28.91±22.32)h长于预后良好组的(19.07±11.74)h,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示:cTnI、Myo、CK-MB、BNP、Lac及心功能Killip分级高、入住ICU时间长为影响AMI患者PCI术预后的危险因素,血管活性药物使用、EF高为影响AMI患者PCI术预后的保护因素(P<0.05)。结论cTnI、Myo、CK-MB、BNP、Lac水平及Killip分级、EF、入住ICU时间、血管活性药物使用情况是AMI患者PCI术预后的影响因素,能为临床提高AMI患者PCI术预后提供参考。Objective To analyze the application value of serum cardiac troponin I(cTnI),myoglobin(Myo),and creatine kinase isoenzyme(CK-MB)combined with clinical features in prognostic assessment of acute myocardial infarction patients undergoing percutaneous coronary intervention(PCI).Methods The clinical data of 100 AMI patients who underwent PCI and were admitted to the intensive care unit(ICU)were retrospectively analyzed.A 3-month follow-up investigation was conducted,and the patients were divided into a good prognosis group(69 cases)and a poor prognosis group(31 cases)based on the follow-up results.The gender,age,smoking history,hypertension history,diabetes history,hyperlipidemia history,chest pain duration,duration of ICU stay,vasoactive drug use,Killip classification,number of stents implanted,stent length,stent diameter,stent site,triglyceride(TG),high density lipoprotein cholesterol(HDL-C),and low density lipoprotein cholesterol(LDL-C),blood glucose(Glu),lactic acid(Lac),cTnI,Myo,CK-MB,brain natriuretic peptide(BNP),ejection fraction(EF)of patients were collected.Multivariate Logistic regression analysis was used to analyze the influencing factors of poor prognosis of AMI patients after PCI.Results Univariate analysis showed that:the poor prognosis group had cTnI of(337.66±245.40)pg/ml,Myo of(969.53±604.58)ng/ml,CK-MB of(115.73±75.84)U/L,BNP of(6225.09±5960.66)pg/ml,Lac of(3.51±2.64)mmol/L and Killip classification of(2.77±1.17)grades,which were higher than(218.99±161.20)pg/ml,(438.99±367.11)ng/ml,(62.57±61.27)U/L,(2928.23±2332.67)pg/ml,(2.18±1.20)mmol/L and(1.36±0.86)grades in the good prognosis group;the rate of vasoactive drug use and EF in the poor prognosis group were 12.9%(4/31)and(51.65±9.84)%,which were lower than 63.8%(44/69)and(60.83±7.50)%in the good prognosis group;the duration of ICU stay of(28.91±22.32)h in the poor prognosis group was longer than(19.07±11.74)h in the good prognosis group;the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis s

关 键 词：心肌肌钙蛋白I 肌红蛋白 肌酸激酶同工酶 临床特征 急性心肌梗死 经皮冠状动脉介入术 

分 类 号：R541.4[医药卫生—心血管疾病]