急性心肌梗死患者血浆心肌营养素-1水平及对预后预测的价值

摘要

[目的]探讨急性心肌梗死(AMI)患者血浆心肌营养素-1(CT-1)水平的变化及其对预后预测的价值.[方法]检测86例AMI患者入院时血浆CT-1及心肌肌钙蛋白I(cTnI)的浓度,另选24名健康体检者为对照组,根据CT-1浓度将AMI患者分为CT-1<300 pg/mL组(n=52)和CT-1＞300 pg/mL组(n=34),记录患者1个月内发生的心血管事件(心血管意外死亡、心力衰竭、再发心绞痛或再发心肌梗死),观察AMI后CT-1水平的变化、CT-1与cTnI的相关性及其对AMI患者的预后价值.[结果]AMI患者血浆CT-1浓度明显高于对照组(P<0.01);血浆CT-1水平与cTnI 成正相关(r=0.761,P<0.01);CT-1＞300 pg/mL组心血管事件发生率明显高于CT-1<300 pg/mL组(P<0.01);多变量回归分析,CT-1是预测AMI患者发生近期心血管事件的有效指标(RR:1.753,95%CI为1.112～3.438,P=0.012).[结论]血浆CT-1水平能够反映AMI患者心肌坏死程度,也是预测AMI患者发生近期心血管事件的有效指标.%[Objective]To explore the change of plasma cardiotrophin-1(CT-1) and its prognostic value in patients with acute myocardial infarction(AMI). [Methods] The levels of plasma CT-1 and cardiac troponinl (cTnI) were measured in 86 patients with AMI. The other 24 healthy persons served as control group. According the level of CT-1 , the patients with AMI were divided into CT-1＜300pg/ml group(n=52) and CT-1＞300pg/ml group(n=34). The cardiovascular events including cardiovascular accident death, heart failure,recurrent angina pectoris or myocardial infarction were recorded. The change of plasma CT-1 , the correlation between CT-1 and cTnI and the influence of CT-1 on prognosis were observed. [Results] Plasma level of CT1 in AMI patients was obviously higher than that in control group(P＜0.01). Plasma level of CT-1 was positively correlated with cTnI(r=0.761 , P＜0.01). The incidence of cardiovascular events in CT-1＞300pg/mL group was obviously higher than that in CT-1＜300 pg/mL group(P＜0.01). Multivariate analysis showed that CT-1 was an independent predictor of short-term prognosis in patients with AMI(RR∶1.753, 95％ CI∶1.112～3.438, P=0.012). [Conclusion] Plasma CT-1 level can reflect the degree of myocardial necrosis and is also an independent predictor of short-term prognosis in patients with AMI.