和肽素对急性心肌梗死早期诊断及预后判断的价值

朱琛颖; 蔡英; 字海静; 于萍; 庄少伟; 刘学波

doi:10.13201/j.issn.1001-1439.2013.05.016

和肽素对急性心肌梗死早期诊断及预后判断的价值

- 1. 同济大学附属东方医院心内科(上海, 200120);
- 2. 云南省楚州大姚县医院内二科

详细信息

通讯作者: 刘学波,E-mail:lxb70@hotmail.com

中图分类号: R542.2

收稿日期: 2012-10-26

Value of serum copeptin in the early diagnosis and short-term prognosis of acute myocardial infarction

- 1. Department of Cardiology, Shanghai East Hospital Affiliated to Tongji University, Shanghai, 200120, China;
- 2. Chuzhou Dayao County Hospital in Yunnan Province

More Information

Corresponding author: LIU Xuebo, E-mail: lxb70@hotmail.com

Received Date: 26 October 2012

摘要

摘要: 目的：探讨血清和肽素对急性心肌梗死（AMI）早期诊断及预后判断的价值。方法：选择因胸痛就诊且明确诊断为AMI的患者92例（AMI组），分别检测胸痛发作3h内及胸痛发作6、12和24h后血清和肽素、超敏肌钙蛋白T（hs-TnT）水平，并随访1年内主要心血管不良事件（MACE）的发生情况。另选择同期健康体检者60例作为对照组。结果：AMI组胸痛发作3h内血清和肽素水平较对照组明显升高[（1.00±0.45）ng/ml：（0.37±0.62）ng/ml，P<0.01]，此时hs-TnT水平与对照组比较差异无统计学意义（P=0.553）。AMI组胸痛发作6、12h后血清和肽素水平较对照组明显升高[（0.64±0.39）ng/ml：（0.37±0.62）ng/ml、（0.89±0.45）ng/ml：（0.37±0.62）ng/ml，均P<0.01]，此时hs-TnT水平亦较对照组明显升高[（0.81±1.07）ng/ml：0.014ng/ml、（0.74±0.82）ng/ml：0.014ng/ml，均P<0.01]。和肽素诊断AMI的ROC曲线下面积为0.900，优于hs-TnT的0.854（P<0.01）。随访12个月，AMI组8例发生MACE，且发生MACE者在胸痛发作24h后血清和肽素水平比未发生MACE者明显升高[（0.91±0.49）ng/ml：（0.39±0.13）ng/ml，P<0.01]。结论：血清和肽素水平对AMI的早期诊断（胸痛3h内）有较好的敏感性，胸痛发作24h后和肽素水平持续升高提示预后不佳。
- 急性心肌梗死 /
- 和肽素 /
- 早期诊断 /
- 预后
Abstract: Objective: To investigate the value of serum copeptin in the early diagnosis and short-term prognosis of acute myocardial infarction(AMI). Method: Ninety-two AMI patients with chest pain were recruited.The serum levels of copeptin and high sensitivity troponin T(hs-TnT) were detected in all patients within 3 h, 6 h, 12 h, and 24 h after onset of the chest pain.The major adverse cardiovascular events(MACE) were recorded during the follow-up of 12 months. Result: The copeptin level in AMI patients within 3 hours after the onset of pain was significantly higher than that in the normal control(P<0.01), but there was no significant difference in hs-TnT(P=0.553).The levels of serum copeptin and hs-TnT in AMI patients within 6 h or 12 h after the onset of pain were both higher than those in the normal control(P<0.01).The area under ROC curve of copeptin in diagnosis of AMI was better than hs-TnT(0.900 vs 0.854, P<0.01).During the follow-up of 12 months, 8 cases occurred MACE in AMI group, whose copeptin levels within 24 h after the onset of chest pain was significantly higher than those without MACE(P<0.01). Conclusion: Copeptin has a good sensitivity in the early diagnosis of AMI, and it can be used to assess the prognosis of AMI.Copeptin continuous rise indicates poor prognosis.
- acute myocardial infarction /
- copeptin /
- early diagnosis /
- prognosis

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参考文献(6)

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