CAJ | 학술논문

目的：探讨急性心肌梗死（AMI）合并2型糖尿病（T2DM）患者长正五聚蛋白3（PTX3）、N 末端脑钠肽前体（NT-ProBNP）水平的变化及在预后判断中的意义。方法选择63例初发型 AMI 合并 T2DM患者为研究对象（观察组），另外选取同期住院的80例初发型 AMI 未合并糖尿病的患者作为对照组，分别用酶联免疫吸附法（ELISA）及电化学发光法检测血浆 PTX3、NT-ProBNP 浓度；观察患者住院期间及出院12个月内主要心脏不良事件（MACE）发生情况，对观察组中 PTX3、NT-ProBNP 浓度与 MACE 发生情况的相关性进行分析。结果观察组 PTX3、NT-ProBNP 浓度[（8．95±5．06）ng／mL，（1609±1049）pg／mL]显著高于对照组[（7．03±3．70）ng／mL，（1198±809）pg／mL]（P ＝0．010，P ＝0．009）；观察组发生 MACE 的例数（26例）显著高于对照组（15例）（P ＝0．003）；观察组中 MACE 患者的 PTX3、NT-ProBNP 浓度[（10．98±5．45）ng／mL，（2007±1097）ng／mL]显著高于未发生 MACE 患者[（7．53±4．28）ng／mL，（1330±930）ng／mL]（P ＝0．007， P ＝0．010），MACE 患者中死亡者的 PTX3、NT-ProBNP 浓度[（13．88±6．84）ng／mL，（2596±1333）ng／mL]显著高于未死亡者[（9．18±3．52）ng／mL，（1639±751）ng／mL]（P ＝0．029，P ＝0．023）。结论AMI 合并 T2DM患者较未合并糖尿病患者可能发生了更为强烈的炎性反应及心肌损害，有着更差的预后；PTX3、NT-ProBNP联合检测在患者的心肌损害程度及预后判断中具有重要意义。
목적：탐토급성심기경사（AMI）합병2형당뇨병（T2DM）환자장정오취단백3（PTX3）、N 말단뇌납태전체（NT-ProBNP）수평적변화급재예후판단중적의의。방법선택63례초발형 AMI 합병 T2DM환자위연구대상（관찰조），령외선취동기주원적80례초발형 AMI 미합병당뇨병적환자작위대조조，분별용매련면역흡부법（ELISA）급전화학발광법검측혈장 PTX3、NT-ProBNP 농도；관찰환자주원기간급출원12개월내주요심장불량사건（MACE）발생정황，대관찰조중 PTX3、NT-ProBNP 농도여 MACE 발생정황적상관성진행분석。결과관찰조 PTX3、NT-ProBNP 농도[（8．95±5．06）ng／mL，（1609±1049）pg／mL]현저고우대조조[（7．03±3．70）ng／mL，（1198±809）pg／mL]（P ＝0．010，P ＝0．009）；관찰조발생 MACE 적례수（26례）현저고우대조조（15례）（P ＝0．003）；관찰조중 MACE 환자적 PTX3、NT-ProBNP 농도[（10．98±5．45）ng／mL，（2007±1097）ng／mL]현저고우미발생 MACE 환자[（7．53±4．28）ng／mL，（1330±930）ng／mL]（P ＝0．007， P ＝0．010），MACE 환자중사망자적 PTX3、NT-ProBNP 농도[（13．88±6．84）ng／mL，（2596±1333）ng／mL]현저고우미사망자[（9．18±3．52）ng／mL，（1639±751）ng／mL]（P ＝0．029，P ＝0．023）。결론AMI 합병 T2DM환자교미합병당뇨병환자가능발생료경위강렬적염성반응급심기손해，유착경차적예후；PTX3、NT-ProBNP연합검측재환자적심기손해정도급예후판단중구유중요의의。
Objective To investigate the changes of PTX3,NT -ProBNP level and the correlation between them and the prognosis of the patients with AMI combined T2DM.Methods 143 patients with primary AMI were enrolled,of which 63 patients with type 2 diabetes (observation group)and 80 patients with no diabetes (control group).Plasma PTX3 values were measured with ELISA method and NT -ProBNP was detected by the electrochemi luminescence method.All patients were observed for the occurrence of MACE during hospitalization and 12 months after discharge.The correlation between PTX3,NT -ProBNP concentration and occurrence of MACE in observation group were analyzed.Results The PTX3,NT -ProBNP concentration[(8.95 ±5.06)ng/mL,(1 609 ±1 049)pg/mL]in the observation group were significantly higher than those in the control group[(7.03 ±3.70)ng/mL,(1 198 ± 809)pg/mL](P =0.010,P =0.009);The number(n =26)of patients with occurrence of MACE in the observation group was significantly higher than 15 cases in the control group(P =0.003).In the observation group,the PTX3, NT -ProBNP concentration[(10.98 ±5.45)ng/mL,(2 007 ±1 097)ng/mL]in patients with MACE were signifi-cantly higher than those in patients without MACE[(7.53 ±4.28)ng/mL,(1330 ±930)ng/mL](P =0.007,P =0.010),and in MACE group,the PTX3,NT -ProBNP concentration[(13.88 ±6.84)ng/mL,(2 596 ±1 333)ng/mL] in patients with death weresignificantly higher than those in patients without death[(9.18 ±3.52)ng/mL,(1 639 ± 751)ng/mL](P =0.029,P =0.023).Conclusion More strong chronic inflammatory reaction and serious myocar-dial injury might occur in the patients with AMI combined and T2DM,and those patients would have poorer prognosis. The combined detection of PTX3,NT -ProBNP has an important significance in evaluating of the degree of myocardial damage and the prognosis of the patients with AMI combined T2DM.