临床荟萃
臨床薈萃
림상회췌
CLINICAL FOCUS
2015年
2期
188-190,195
,共4页
李敬%王岚%田春辉%刘晓婷%孔繁托%张建军%刘倩%朱保月%柴瑞丽%王维展
李敬%王嵐%田春輝%劉曉婷%孔繁託%張建軍%劉倩%硃保月%柴瑞麗%王維展
리경%왕람%전춘휘%류효정%공번탁%장건군%류천%주보월%시서려%왕유전
中毒%心肌疾病%和肽素%缺血修饰白蛋白
中毒%心肌疾病%和肽素%缺血脩飾白蛋白
중독%심기질병%화태소%결혈수식백단백
poisoning%cardiomyopathies%copeptin%ischemia modified albumin
目的：探讨和肽素(copeptin)与缺血修饰白蛋白(ischemia modified albumin,IMA)联合测定在急性中毒心肌损伤早期诊断中的临床意义。方法选择急性中毒患者276例,根据有无心肌损伤分为心肌损伤组175例和非心肌损伤组101例。健康体检者50例作为对照组,所有入选者在入院1小时内抽取静脉血3 ml,检测心肌酶、心肌肌钙蛋白 T(cTnT)、和肽素、IMA 水平。结果与对照组比较,中毒患者非心肌损伤组与心肌损伤组和肽素、IMA 水平均显著升高(P <0.05)。心肌损伤组与非心肌损伤组比较差异亦有统计学意义(P <0.05)。其中,重度心肌损伤与轻中度比较,和肽素、IMA 水平明显升高,差异有统计学意义(P <0.05)。经 Logistic 回归分析显示,和肽素、IMA、cTnI、心肌酶水平升高的患者出现心血管事件的危险性增加。结论测定和肽素、IMA 水平在急性中毒心肌损伤的早期诊断有重要临床价值,其水平与心肌损伤的严重程度有关,即损伤越重,其含量越高。
目的：探討和肽素(copeptin)與缺血脩飾白蛋白(ischemia modified albumin,IMA)聯閤測定在急性中毒心肌損傷早期診斷中的臨床意義。方法選擇急性中毒患者276例,根據有無心肌損傷分為心肌損傷組175例和非心肌損傷組101例。健康體檢者50例作為對照組,所有入選者在入院1小時內抽取靜脈血3 ml,檢測心肌酶、心肌肌鈣蛋白 T(cTnT)、和肽素、IMA 水平。結果與對照組比較,中毒患者非心肌損傷組與心肌損傷組和肽素、IMA 水平均顯著升高(P <0.05)。心肌損傷組與非心肌損傷組比較差異亦有統計學意義(P <0.05)。其中,重度心肌損傷與輕中度比較,和肽素、IMA 水平明顯升高,差異有統計學意義(P <0.05)。經 Logistic 迴歸分析顯示,和肽素、IMA、cTnI、心肌酶水平升高的患者齣現心血管事件的危險性增加。結論測定和肽素、IMA 水平在急性中毒心肌損傷的早期診斷有重要臨床價值,其水平與心肌損傷的嚴重程度有關,即損傷越重,其含量越高。
목적：탐토화태소(copeptin)여결혈수식백단백(ischemia modified albumin,IMA)연합측정재급성중독심기손상조기진단중적림상의의。방법선택급성중독환자276례,근거유무심기손상분위심기손상조175례화비심기손상조101례。건강체검자50례작위대조조,소유입선자재입원1소시내추취정맥혈3 ml,검측심기매、심기기개단백 T(cTnT)、화태소、IMA 수평。결과여대조조비교,중독환자비심기손상조여심기손상조화태소、IMA 수평균현저승고(P <0.05)。심기손상조여비심기손상조비교차이역유통계학의의(P <0.05)。기중,중도심기손상여경중도비교,화태소、IMA 수평명현승고,차이유통계학의의(P <0.05)。경 Logistic 회귀분석현시,화태소、IMA、cTnI、심기매수평승고적환자출현심혈관사건적위험성증가。결론측정화태소、IMA 수평재급성중독심기손상적조기진단유중요림상개치,기수평여심기손상적엄중정도유관,즉손상월중,기함량월고。
Objective To explore the clinical significance of combined determination of copeptin and ischemia-modified albumin(IMA)in the early diagnosis of acute poisoning myocardial injury.Methods A total of 276 patients with acute poisoning,including 1 75 cases with myocardial injury and 101 cases without myocardial injury,were enrolled in this study.Fifty healthy subjects were recruited as control group.Blood sample of each subject was collected within 1 h after admission for the detection of myocardial enzymes,cTnI,copeptin and IMA.Results Compared with the control group,copeptin and IMA levels in patients with acute poisoning elevated significantly (P <0.05).The levels of copeptin and IMA in myocardial injury group were also remarkably different from those in non-myocardial injury group (P < 0.05 ).Among patients with myocardial injury,the levels of copeptin and IMA in patients with severe myocardial injury were markedly higher than those in patients with mild to moderate myocardial injury (P < 0.05 ).Logistic regression analysis showed the risk of cardiovascular events increased in patients with elevated copeptin,IMA,cTnI and myocardial enzymes levels.Conclusion Determination of copeptin and IMA has important clinical value in the early diagnosis of myocardial injury of acute poisoning.The serum levels of copeptin and IMA are positively correlated with the severity of myocardial injury.
