急性ST段抬高型心肌梗死合并左室肥厚患者血清超敏肌钙蛋白T水平及其与心肌厚度的相关性

doi:10.3969/j.issn.1671-7171.2023.05.008

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摘要【目的】分析急性ST段抬高型心肌梗死合并左室肥厚患者血清超敏肌钙蛋白T(hs-TnT)水平及其与心肌厚度的相关性。【方法】选取2019年7月至2021年5月本院心血管内科收治的90例急性ST段抬高型心肌梗死患者,根据是否合并左室肥厚将其分为观察组(合并左室肥厚,n=45)和对照组(未合并左室肥厚,n=45)。比较两组hs-TnT、血清肌酸激酶同工酶(CK-MB)、氨基末端B型脑钠肽前体(NT-proBNP)水平。比较两组左室舒张末期内径、左室后壁厚度、室间隔厚度及左室心肌质量变化。分析血清hs-TnT与心肌厚度的相关性。【结果】观察组患者血清NT-proBNP水平高于对照组,差异有统计学意义(P<0.05)。观察组患者血清hs-TnT、CK-MB水平均高于对照组,差异有统计学意义(P<0.05)。观察组患者左室舒张末期内径、左室后壁厚度、室间隔厚度及左室心肌质量指数均高于对照组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,血清hs-TnT与左室舒张末期内径、左室后壁厚度、室间隔厚度、左室心肌质量指数呈显著正相关(r=0.459、0.572、0.537、0.738,均P<0.05)。死亡组患者血清CK-MB、hs-TnT水平高于存活组(P<0.05),两组血清NT-proBNP水平比较,差异无统计学意义(P>0.05)。Logistic回归分析显示,血清hs-TnT水平升高是心肌梗死合并心肌肥厚患者死亡的独立危险因素(P<0.05)。【结论】血清hs-TnT水平与心肌厚度具有明显相关性,急性ST段抬高型心肌梗死伴心肌肥厚患者血清hs-TnT显著升高,且短期内死亡风险升高,血清hs-TnT水平升高是此类患者病死的独立危险因素。

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	郭瑛
	孙育民
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	张雁

关键词 ：心肌梗死/并发症, 急性病, 肥大, 左心室/并发症, 肌钙蛋白T

Abstract：【Objective 】To analyze the serum levels of hypersensitive troponin T (hs-TnT) and its correlation with myocardial thickness in patients with acute ST segment elevation myocardial infarction and left ventricular hypertrophy. 【Methods】 A total of 90 patients with acute ST segment elevation myocardial infarction admitted to the Department of Cardiovascular Medicine of our hospital from July 2019 to May 2021 were selected and divided into an observation group (with left ventricular hypertrophy,n=45) and a control group (without left ventricular hypertrophy,n=45) based on whether left ventricular hypertrophy was present. The levels of hs-TnT,serum creatine kinase isoenzyme (CK-MB),and N-terminal brain natriuretic peptide precursor (NT-proBNP) were compared between two groups of patients. The changes of left ventricular end diastolic diameter,left ventricular posterior wall thickness,interventricular septum thickness and left ventricular myocardial mass were compared between the two groups. The correlation between serum hs-TnT and myocardial thickness was analyzed. 【Result】 The serum NT-proBNP levels in the observation group were higher than those in the control group,with a statistically significant difference (P<0.05). The serum levels of hs-TnT and CK-MB in the observation group were higher than those in the control group,with statistical significance (P<0.05). The left ventricular end diastolic diameter,left ventricular posterior wall thickness,interventricular septum thickness and left ventricular myocardial mass index in the observation group were significantly higher than those in the control group (P<0.05). Pearson correlation analysis showed that serum hs-TnT was significantly positively correlated with left ventricular end diastolic diameter,left ventricular posterior wall thickness,interventricular septum thickness,and left ventricular myocardial mass index (r=0.459,0.572,0.537,0.738,all P<0.05). The serum levels of CK-MB and hs-TnT in the death group were higher than those in the survival group (P<0.05),and there was no statistically significant difference in serum NT-proBNP levels between the two groups (P>0.05). Logistic regression analysis showed that serum hs-TnT levels were an independent risk factor for death in patients with myocardial infarction and myocardial hypertrophy (P<0.05). 【Conclusion】 There is a significant correlation between serum hs-TnT levels and myocardial thickness. Patients with acute ST segment elevation myocardial infarction and myocardial hypertrophy have a significant increase in serum hs-TnT levels,and the risk of short-term death is increased. Serum hs -TnT levels are an independent risk factor for mortality in such patients.

Key words： Myocardial Infarction/CO Acute Disease Hypertrophy, Left Ventricular/CO Troponin T

收稿日期: 2022-04-27

中图分类号:

R542.22

基金资助:上海市 2022 年度“科技创新行动计划” 自然科学基金项目(22ZR1454100)

通讯作者: **E-mail:sunyumin@fudan.edu.cn

引用本文:

郭瑛, 孙育民, 曹宾, 张雁. 急性ST段抬高型心肌梗死合并左室肥厚患者血清超敏肌钙蛋白T水平及其与心肌厚度的相关性[J]. 医学临床研究, 2023, 40(5): 669-672.
GUO Ying, SUN Yu-min, CAO Bin, et al. Serum Levels of Hypersensitive Troponin T and its Correlation with Myocardial Thickness in Patients with Acute ST Segment Elevation Myocardial Infarction and Left Ventricular Hypertrophy. JOURNAL OF CLINICAL RESEARCH, 2023, 40(5): 669-672.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.05.008 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I5/669

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