急性心肌梗死患者cTnI峰值对早期预后的影响

目的：观察急性心肌梗死（AMI）患者心肌肌钙蛋白I（cTnI）峰值对早期预后的影响，并比较不同峰值与预后的相关关系。方法：入选急性ST段抬高心肌梗死（STEMI）患者286例，根据住院期间不同治疗方式分为：〈6h行PCI治疗者为组1（11=100）；6～12h行PCI治疗者为组2（n=96）；采取药物治疗者为组3（n=90）。入选所有患者入院即刻取2mL静脉血分别放入2个抗凝管中测定cTnI，测定cTnI，入院立刻给予测定一次，之后每2～4h测定一次，达到峰值后，每2～3d测定一次，直到cTnI恢复正常。2周内行超声心动图检查，观察住院期间心血管事件发生者的cTnI峰值及各区间分组的死亡率。结果：（1）组1、组2、组3的心功能异常者cTnI峰值显著高于心功能正常者，有统计学意义（P〈0．05）；死亡患者cTnI峰值显著高于心功能正常患者，有统计学意义（P〈0．001）．组1与组2、组3比较LVEF均有显著性差异（P〈0．05，P〈0．01）。（2）急性心肌梗死患者死亡率随着cTnI峰值的升高而升高，有统计学意义（P〈0．05）。（3）急性心肌梗死患者cTnI峰值与LVEF显著负相关（P〈0．05）。结论：cTnI的峰值与急性心肌梗死的早期预后密切相关；急性心肌梗死患者cTnI的峰值越高其早期预后越差，心功能越差，死亡率越高；急性心肌梗死患者cTnI的峰值测定有利于对高危患者进行临床指导及治疗。6h内行介入治疗明显改善心功能。

THE IMPACT OF CARFIAC TROPONIN L (CTNL) PEAK ON THE PATIENTS WITH ACUTE MYOCARDIAL INFARCTION (AML) ON THE SHORT-TERM PROGNOSIS

Objective：To observe the influence of cardiac troponin I（cTnI） peak on acute the patientswith myocardial infarction （AMI） on the short -term prognosis and compare the correlation between different peaks and prognosis. Methods：Based on the different treatment modalities of patients they can be divided into： Group 1 （n = 100）, Group 2 （n = 96） and Group 3 （n = 90） ; based on the acute myocardial infarction, the results can be divided into a normal group （n = 190） and an abnormal group （n =96） in cardiac function; to observe the different correlation between different peaks and prognosis by dividing the interval into 5 sub - groups. Results： （ 1 ） In Group 1, Group 2, Group 3, abnormal cardiac function cTnI peak was significantly higher than normal cardiac function, which has statistical significance （ p 〈 0.05 ） ; the cTnI peaks of dead patients with acute myocardial infarction are significantly higher than those with normal cardiac function, which has statistical significance（p 〈 0.01 ）. There was significant difference in LVEF compared Group 1 with Group 2 and Group 3. （2） The mortality in patients with acute myocardial infarction increases as cTnI peaks were elevated, which has statistical significance （ p 〈 0.05 ）. （3） The cTnI peaks of patients with acute myocardial infarction were significantly and negatively correlated with their LVEF（r = - 0.744 p 〈0.01 ）. Conclusion： （1） cTnI peak is closely related to the short -term prognosis of Acute Myocardial Infarction; （2）The higher the cTnI peak of patient with acute myocardial infarction is ,the worse his heart function is the worse his short -term prognosis the higher his mortality is （3）The cTnI peak Determination of patients with acute myocardial infarction is helpful for clinical guidance and treatment to high - risk patients. After interventional therapy in 6 hours, heart function is obviously improved.