Diagnostic value of copeptin combined with hypersensitive cardiac troponin T detection in early acute myocardial infarction: A protocol of randomized double-blind diagnostic trial

Background:The sensitivity and specificity of the routine detection of acute myocardial infarction (AMI) in early diagnosis are not high, which can not meet the clinical needs. Copeptin combined with hypersensitive cardiac troponin T (hs-cTnT) is a new detection scheme, and its value in the early diagnosis of acute myocardial infarction is still unclear. Accordingly, the aim of this study is to evaluate the diagnostic value of copeptin combined with hypersensitive troponin T detection in early acute myocardial infarction.Methods:This is a prospective, randomized; double-blind diagnostic trial to investigate the diagnostic value of copeptin combined with hypersensitive troponin T detection in early acute myocardial infarction. Approved by the clinical research ethics of our hospital. Patients were randomly divided into one of 2 test protocols: (A) copeptin combined with hs-cTnT group and (B) cardiac troponin I (cTnI) group. Patients, doctors, nurses, inspectors, and data-gathering assistants were blinded to group allocation. We will focus on the sensitivity comparison of the 2 detection methods at different time periods and the sensitivity and specificity comparison of the two detection methods. Data were analyzed using the statistical software package SPSS version 25.0 (Chicago, IL).Discussion:The purpose of this study is to evaluate the diagnostic value of copeptin combined with hypersensitive cardiac troponin T detection in early acute myocardial infarction. The results of this study will establish clinical evidence for the detection of high sensitivity cardiac troponin T in the early diagnosis of acute myocardial infarction.Ethics and dissemination:Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.OSF Registration number:DOI 10.17605/OSF.IO/6TE5Z.     

急性脑出血患者血浆N端脑钠肽前体、和肽素的检测及其临床意义

目的：探讨急性脑出血患者血浆 N 端脑钠肽前体（NT-proBNP）及和肽素与病情严重程度及脑出血量之间的关系。方法选取该院2011年12月至2013年6月期间诊断为急性脑出血患者109例（脑出血组）和同期体检的健康者32例（对照组）,对脑出血组患者和对照组健康者血浆 NT-proBNP、和肽素水平与格拉斯哥昏迷评分（GCS）进行比较。结果脑出血组血浆NT-proBNP 及和肽素水平明显高于对照组,随病情严重程度及出血量增加呈显著升高,差异有统计学意义（P ＜0．05）。血浆 NT-proBNP、和肽素水平与脑出血量呈正相关（r＝0．63,r＝0．58,P ＜0．01）,与 GCS 呈负相关（r＝－0．52,r＝－0．46,P ＜0．01）。结论血浆 NT-proBNP、和肽素水平和急性脑出血关系密切,能反映急性脑出血患者病情严重程度。     

血清和肽素、降钙素原对脑出血合并肺部感染早期诊断及判断预后的价值

目的：研究血清和肽素、降钙素原（PC T ）与脑出血合并肺部感染患者早期诊断及预后之间的关系。方法选取该院2012年1月至2013年12月诊断为脑出血、脑出血合并肺部感染患者共120例及同期体检的健康者60例（对照组）,比较3组血清和肽素与PC T水平的差异。结果脑出血合并肺部感染组和肽素、PC T水平均高于脑出血组和对照组,差异有统计学意义（P＜0．05）。脑出血合并肺部感染生存组血清和肽素、PCT、C反应蛋白（CRP）水平及急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分均明显低于死亡组,差异有统计学意义（P＜0．05）。结论血清和肽素、PCT 和脑出血合并肺部感染关系密切,对脑出血合并肺部感染患者早期诊断及预后具有重要临床价值。     

Rapid rule out of myocardial infarction with the use of copeptin as a biomarker for cardiac injury

Copeptin is a non‐specific marker of an endogenous stress response. A dual biomarker marker approach involving the simultaneous use of troponin and copeptin assays may assist early exclusion of acute coronary syndrome in Australian emergency departments. The utility and limitations of this approach are discussed.     

Diabetes insipidus complicating apoplexy during pregnancy: the potential use of copeptin

Pituitary apoplexy during pregnancy is rare but important to recognise, particularly in the hyperoestrogenaemic state when known lactotroph hyperplasia occurs. Untreated, the complication rates from pituitary adenomas depend on the size of the adenoma before pregnancy. A history of thirst plus polydipsia during pregnancy raises suspicion for diabetes insipidus and a 24‐h urine collection quantifying polyuria with an inappropriately low urine osmolality confirms the diagnosis. Further evaluation for assessing diabetes insipidus in pregnancy may be facilitated by the use of a copeptin.     

冠心病患者血浆和肽素水平的测定及其对冠脉病变程度的诊断价值

目的:测定冠心病(CHD)患者血浆和肽素(copeptin)水平,探讨其对冠脉病变严重程度的诊断价值.方法:选取因疑似CHD住院而进行冠状动脉造影(CAG)检查的180例患者,按CAG结果分为CHD组(n=101)与对照组(n=79).CHD组根据冠脉病变支数分为单支病变组(n=38)、双支病变组(n=34)、三支病变组(n=29);根据Gensini积分分为<20分(n=40)、20～40分(n=29)、≥40分(n=32)组.所有患者造影前均测定收缩压(SBP)、舒张压(DBP)等一般临床特征及生化指标;采用和肽素酶联试剂盒测定血浆copeptin水平,比较不同组别患者copeptin水平,探讨其诊断意义.结果:冠心病患者血浆copeptin水平(ng/ml)显著高于对照组(0.953 6±0.098 6 vs 0.924 4±0.064 9,P＜0.05).冠状动脉双支病变、三支病变组血浆copeptin水平显著高于对照组和单支病变组(P＜0.05),但前两者间无统计学差异;Gensini积分20～40分、≥40分组患者血浆copeptin水平显著高于对照组和＜20分组(P＜0.05),但前两者间无统计学差异.结论:冠心病患者血浆copeptin水平较高,其在一定程度内可以反映冠脉病变程度,但对于严重冠脉病变可能鉴别意义不大.