BNP、cTnI检测对非糖尿病急性心肌梗死合并应急性高血糖临床价值的探讨

doi:10.3969/j.issn.1673-8640.2014.01.014

检验医学 ›› 2014, Vol. 29 ›› Issue (1): 57-60.DOI: 10.3969/j.issn.1673-8640.2014.01.014

BNP、cTnI检测对非糖尿病急性心肌梗死合并应急性高血糖临床价值的探讨

陈冬莲¹, 曾凡鹏², 杜志林², 罗卫平², 梁妙芝¹, 杨莹¹

1.清远市中医院检验科, 广东清远 511500;
2.清远市中医院心内科, 广东清远 511500

收稿日期:2013-03-13 出版日期:2014-01-20 发布日期:2014-01-20
作者简介:陈冬莲, 女, 1965年生, 学士, 主任技师, 主要从事心源性疾病及心脏标志物检测的临床研究。

Investigation on the clinical significance of BNP and cTnI detections in AMI patients with non-diabetic irritable hyperglycosemia

CHEN Donglian¹, ZENG Fanpeng², DU Zhilin², LUO Weiping², LIANG Miaozhi¹, YANG Ying¹.

1. Department of Clinical Laboratory, Qingyuan Traditional Chinese Medicine Hospital, Guangdong Qingyuan 511500, China;2. Department of Cardiology, Qingyuan Traditional Chinese Medicine Hospital, Guangdong Qingyuan 511500, China

Received:2013-03-13 Online:2014-01-20 Published:2014-01-20

摘要/Abstract

摘要： 目的探讨B型钠尿肽(BNP)及心肌肌钙蛋白I(cTnI)水平在非糖尿病急性心肌梗死(AMI)合并应激性高血糖患者近期预后评估中的作用。方法将122例AMI患者按空腹血糖水平分为非糖尿病AMI合并应激性高血糖组(简称试验组, 68例)和AMI未合并应激性高血糖组(简称对照组, 54例), 检测发病后24 h的BNP及cTnI水平。所有入选患者入院后2周行心功能测定, 并对超声心动图参数进行分析, 同时行24 h动态心电图检测, 记录患者入院时心率及心律失常发生率, 并观察住院2周内心力衰竭、心源性休克的发生率, 并对结果进行回顾性分析。结果试验组发病后24 h的cTnI、BNP水平及心率分别为(10.41±6.83)μg/L、(1 713.6±687.03)ng/L、(86±12)次/min, 均高于对照组[(5.41±2.86)μg/L、(495.61±464.39)ng/L、(77±11)次/min](P<0.05、P<0.01)。BNP与cTnI呈正相关(r²=0.753, r=0.868, P<0.01)。试验组恶性心律失常、心力衰竭、心源性休克的发生率与对照组比较差异均有统计学意义(P<0.05)。试验组左心室射血分数(LVEF)、左室短轴缩短率(LVFS)结果分别为48.83%±5.01%、24.88%±6.53%, 均明显低于对照组(54.82%±5.29%、30.86%±5.89%)(P<0.01)。结果 BNP及cTnI的水平可以判断非糖尿病AMI合并应激性高血糖患者病情危重程度, 对近期预后可做出评估。BNP和cTnI可作为判断非糖尿病AMI合并应激性高血糖患者危险性的指标。

关键词: B型钠尿肽, 心肌肌钙蛋白I, 急性心肌梗死, 高血糖

Abstract: Objective To study the roles of B-type natriuretic peptide (BNP) and cardiac troponin I (cTnI) detections in the recent prognosis evaluation of acute myocardial infarction (AMI) patients with non-diabetic irritable hyperglycosemia. Methods According to the Results of fasting blood glucose test, 122 AMI patients were enrolled and classified into 2 groups, AMI patients with non-diabetic irritable hyperglycosemia (experimental group, 68 cases) and AMI patients without non-diabetic irritable hyperglycosemia (control group, 54 cases). The BNP and cTnI levels were detected after the onsets for 24 h. The cardiac function tests were performed for all the patients 2 weeks after admission. Their echocardiographic parameters were analyzed, meanwhile the 24 h dynamic electrocardiogram detection was performed. The heart rate and the incidence of arrhythmia were recorded, and the incidences of heart failure and cardiogenic shock within the 2 weeks were observed and analyzed retrospectively. Results The experimental group showed that the cTnI level was (10.41±6.83) μg/L, BNP level was ( 1 713.6±687.03) ng/L, and heart rate was (86±12)/min, which were significantly higher than those in control group [(5.41±2.86) μg/L, (495.61±464.39) ng/L and (77±11)/min, respectively](P<0.05, P<0.01). The levels of BNP and cTnI had a positive correlation(r²=0.753, r=0.868, P<0.01). The differences on the incidence rates of malignant arrhythmia, heart failure and cardiogenic shock between experimental and control groups were statistically significant (P<0.05). In experimental group, the left ventricular ejection fraction(LVEF) was 48.83%±5.01%, and the left ventricular fractional shortening(LVFS) was 24.88%±6.53%, which were lower than those in control group (54.82%±5.29% and 30.86%±5.89%)(P<0.01). Results The BNP and cTnI levels can help for judging the severity of AMI patients with non-diabetic irritable hyperglycosemia and evaluate the recent prognosis. BNP and cTnI can be used as risk indicators for AMI patients with non-diabetic irritable hyperglycosemia.

Key words: B-type natriuretic peptide, Cardiac troponin I, Acute myocardial infarction, Hyperglycosemia

中图分类号:

R446.1

陈冬莲, 曾凡鹏, 杜志林, 罗卫平, 梁妙芝, 杨莹. BNP、cTnI检测对非糖尿病急性心肌梗死合并应急性高血糖临床价值的探讨[J]. 检验医学, 2014, 29(1): 57-60.

CHEN Donglian, ZENG Fanpeng, DU Zhilin, LUO Weiping, LIANG Miaozhi, YANG Ying.. Investigation on the clinical significance of BNP and cTnI detections in AMI patients with non-diabetic irritable hyperglycosemia[J]. , 2014, 29(1): 57-60.

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BNP、cTnI检测对非糖尿病急性心肌梗死合并应急性高血糖临床价值的探讨

Investigation on the clinical significance of BNP and cTnI detections in AMI patients with non-diabetic irritable hyperglycosemia

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