中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
4期
300-302
,共3页
游志刚%姜醒华%吴延庆%吴清华%程开诚%程晓曙%苏海
遊誌剛%薑醒華%吳延慶%吳清華%程開誠%程曉曙%囌海
유지강%강성화%오연경%오청화%정개성%정효서%소해
急性心肌梗死%肌钙蛋白Ⅰ%预后%主要心血管事件
急性心肌梗死%肌鈣蛋白Ⅰ%預後%主要心血管事件
급성심기경사%기개단백Ⅰ%예후%주요심혈관사건
Acute myocardial infarction%Cardiac troponin Ⅰ%Prognosis%Major cardiovascular events
目的 探讨急性心肌梗死(AMI)患者发病第7天肌钙蛋白Ⅰ(cTnI)水平在预后中的判断价值.方法 161例AMI患者依照采取的治疗方法分为急诊冠状动脉介入(PCI)治疗组(35例),延期PCI组36例和药物治疗组90例,30例无器质性心脏病者为对照组.观察第7天不同cTnI水平组的主要心血管事件(MACE)发生率.结果 AMI患者发病第7天cTnI水平[(5.76±4.27)μg/L]显著高于对照组[(0.15±0.10)μg/L](P<0.01);按第7天cTnI转阴率分析:总转阴率39.1%,其中急诊PCI治疗组转阴率(68.6%)高于延期PCI组(36.1%)和单纯药物治疗组(28.9%);按心血管事件(MACE)发生率分析:cTnI阳性组总MACE发生率(34.7%)高于cTnI阴性组(1.6%)(P<0.01);发生MACE者第7天cTnI值(13.99±8.39)μg/L明显高于不发生MACE者(3.65±2.55)μg/L(P<0.01);按cTnI水平分析:心脏性死亡、总MACE的发生率随cTnI的水平升高而增加(P<0.05),cTnI>9.0μg/L者最高.结论 发病第7天cTnI水平在AMI患者预后判断中有重要价值,是预测AMI患者总MACE发生率增高的独立预后因素.
目的 探討急性心肌梗死(AMI)患者髮病第7天肌鈣蛋白Ⅰ(cTnI)水平在預後中的判斷價值.方法 161例AMI患者依照採取的治療方法分為急診冠狀動脈介入(PCI)治療組(35例),延期PCI組36例和藥物治療組90例,30例無器質性心髒病者為對照組.觀察第7天不同cTnI水平組的主要心血管事件(MACE)髮生率.結果 AMI患者髮病第7天cTnI水平[(5.76±4.27)μg/L]顯著高于對照組[(0.15±0.10)μg/L](P<0.01);按第7天cTnI轉陰率分析:總轉陰率39.1%,其中急診PCI治療組轉陰率(68.6%)高于延期PCI組(36.1%)和單純藥物治療組(28.9%);按心血管事件(MACE)髮生率分析:cTnI暘性組總MACE髮生率(34.7%)高于cTnI陰性組(1.6%)(P<0.01);髮生MACE者第7天cTnI值(13.99±8.39)μg/L明顯高于不髮生MACE者(3.65±2.55)μg/L(P<0.01);按cTnI水平分析:心髒性死亡、總MACE的髮生率隨cTnI的水平升高而增加(P<0.05),cTnI>9.0μg/L者最高.結論 髮病第7天cTnI水平在AMI患者預後判斷中有重要價值,是預測AMI患者總MACE髮生率增高的獨立預後因素.
목적 탐토급성심기경사(AMI)환자발병제7천기개단백Ⅰ(cTnI)수평재예후중적판단개치.방법 161례AMI환자의조채취적치료방법분위급진관상동맥개입(PCI)치료조(35례),연기PCI조36례화약물치료조90례,30례무기질성심장병자위대조조.관찰제7천불동cTnI수평조적주요심혈관사건(MACE)발생솔.결과 AMI환자발병제7천cTnI수평[(5.76±4.27)μg/L]현저고우대조조[(0.15±0.10)μg/L](P<0.01);안제7천cTnI전음솔분석:총전음솔39.1%,기중급진PCI치료조전음솔(68.6%)고우연기PCI조(36.1%)화단순약물치료조(28.9%);안심혈관사건(MACE)발생솔분석:cTnI양성조총MACE발생솔(34.7%)고우cTnI음성조(1.6%)(P<0.01);발생MACE자제7천cTnI치(13.99±8.39)μg/L명현고우불발생MACE자(3.65±2.55)μg/L(P<0.01);안cTnI수평분석:심장성사망、총MACE적발생솔수cTnI적수평승고이증가(P<0.05),cTnI>9.0μg/L자최고.결론 발병제7천cTnI수평재AMI환자예후판단중유중요개치,시예측AMI환자총MACE발생솔증고적독립예후인소.
Objective To investigate whether the serum level of cardiac troponin Ⅰ (cTnI) at the 7th day after acute myocardial infarction (AMI) is a predictive factor of the prognosis of patients. Methods One hundred and sixty-one patients with AMI were divided into three groups (emergency percutaneous coronary intervention (PCI) group, delayed PCI group and drug therapy group). Thirty patients without organic heart disease as a control group. The levels of cTnI at the 7th day after AMI were measured by chemoluminescence technique. Major cardio-vascular events (MACEs) were recorded on admission and during follow-up period. The correlation between cTnI serum levels and the incidence of MACEs was analyzed. Results Compared to the control group, the levels of cTnI were significantly increased at the 7th day in AMI patients (P<0.01). The total negative-conversion rate on the 7th day was 39.1%, the negative-conversion rate was higher in emergency PCI group compared to delayed PCI group and drug therapy group (68.6% vs 36.1% and 28.9%, P<0.01). The incidence of MACEs in AMI patients with cTnI<1.5 μg/L was significantly lower than that in AMI patients with cTnI≥1.5 μg/L(1.6% vs 34.7%, P< 0.01). The serum level of cTnI in AMI patients with MACEs was higher than that in AMI patients without MACEs (P<0.01). The incidence of MACEs was correlated with the serum level of cTnI in AMI patients (P<0.05). The incidence of MACEs in AMI patients with cTnI>9.0 μg/L was the highest among all AMI patients (P<0.05). Conclusions The serum level of cTnI at the 7th day in patients after an episode of AMI is an independent predictor for the prognosis.
