和肽素在急性心肌梗死致心源性猝死法医病理学诊断中的应用
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摘要
猝死作为一种严重危害人类生命健康的综合征,在临床实践和法医鉴定过程中受到高度的重视。所有的猝死类型中以心源性猝死最为常见,这也一直是法医病理学鉴定和研究的重点难点。急性心肌梗死在心源性猝死病因构成比中居首位,故如何界定早期急性心肌梗死是法医学研究的热点,同时也是临床防范心肌梗死发生发展的关键环节。本文对和肽素的结构、生理病理作用、临床及法医学应用、法医病理诊断应用前景进行综述,旨在分析和肽素是否能够作为检测指标用于急性心肌梗死致心源性猝死的诊断和法医病理鉴定当中,并为进一步研究其病理生理机制提供参考。
Sudden death is a serious syndrome, threating to human life and health, thus having received high attention in clinical practice and forensic identi?cation. As the commonest type of sudden death, sudden cardiac death has long been focused in the forensic pathology identi?cation and research. Acute myocardial ischemia is the most crucial cause of sudden death due to sudden cardiac death. Therefore, how to define the early acute myocardial ischemia is a hotspot in forensic research, also a key pivot in clinical prevention against myocardial infarction. This article reviews about copeptin of its structure, physiological and pathological roles, clinical diagnostic value and forensic applicable prospects, aiming to analyze whether it can be used as an indicator of early myocardial ischemia for sudden cardiac death, and provide reference for further study on pathophysiological mechanism of sudden death.
Sudden death is a serious syndrome, threating to human life and health, thus having received high attention in clinical practice and forensic identi?cation. As the commonest type of sudden death, sudden cardiac death has long been focused in the forensic pathology identi?cation and research. Acute myocardial ischemia is the most crucial cause of sudden death due to sudden cardiac death. Therefore, how to define the early acute myocardial ischemia is a hotspot in forensic research, also a key pivot in clinical prevention against myocardial infarction. This article reviews about copeptin of its structure, physiological and pathological roles, clinical diagnostic value and forensic applicable prospects, aiming to analyze whether it can be used as an indicator of early myocardial ischemia for sudden cardiac death, and provide reference for further study on pathophysiological mechanism of sudden death.
引文
[1]从斌.法医病理学[M].5版.北京:人民卫生出版社,2016:381-416.
[2]KEHL D W,IQBAL N,FARD A,et al.Biomarkers in acute myocardial injury[J].Translational Research,2012,159(4):252-264.
[3]KHAN S,DHILLON O,OBRIEN R,et al.C-terminal prova-sopressin(copeptin)as a novel and prognostic marker in acute myocardial infarction:leicester acute myocardial infarction peptide(LAMP)study[J].Circulation,2017,115(16):2103-2110.
[4]刘晓斌,黄子扬.生长分化因子15与心血管疾病[J].中华高血压杂志,2012(3):228-231.
[5]WOLLERT K C,KEMPF T,PETER T,et al.Prognostic value of growth-differentiation factor 15 in patients with nonST-segment elevation acute coronary syndrome[J].Circula-tion,2007,115(8):962-971.
[6]MORGENTHALER N G,STRUCK J,ALONSO C,et al.Assay for the measurement of copeptin,a stable peptide de-rived from the precursor of vasopressin[J].Clinical Chemis-try,2006,5:112-119.
[7]BALANESCU S,KOPP P,GASKILL M B,et al.Correlation of plasma copeptin and vasopress in concentrations in hypoisoand hyperosmolar states[J].Journal of Clinical Endocrinology&Metabolism,2011,96:1046-1052.
[8]CHRIST-CRAIN M,FENSKE W.Copeptin in the diagnosis of vasopressin-dependent disorders of fluid homeostasis[J].Nature Reviews Endocrinology,2016,12:168-176.
[9]BOECKEL J N,OPPERMANN J,ANADOL R,et al.Analyz-ing the release of copeptin from the heart in acute myocardial infarction using a transcoronary gradient model[J].Scientific Reports,2016,6:208-212.
[10]BHANDARI S S,LOKE I,DAVIES J E,et al.Gender and renal function influence plasma levels of copeptin in healthy individuals[J].Clinical Science,2009,116:257-263.
[11]BARAT C,SIMPSON L,BRESLOW E.Properties of human vasopressin precursor constructs:inefficient monomer folding in the absence of copeptin as a potential contributor to diabetes insipidus[J].Biochemistry,2004,45(25):8191-8203.
[12]MUELLER C.Biomarkers and acute coronary syndromes:an update[J].European Heart Journal,2014,35(9):552-556.
[13]REINSTADLER S J,KLUG G,FEISTRITZER H J,et al.Long-term predictive value of copeptin after acutemyocardial infarction:a cardiacmagnetic resonance study[J].International Journal of Cardiology,2014,172(2):359-360.
[14]REINSTADLER S J,KLUG G,FEISTRITZER H J,et al.As-sociation of copeptin with myocardial infarct size and myocar-dial function after ST segment elevation myocardial infarction[J].Heart,2013,99(20):1525-1529.
[15]LIPINSKI M J,ESCARCEGA R O,ASCENZO F D,et al.Asystematic review and collaborative meta-analysis to deter-mine the incremental value of copeptin for rapid rule-out of acute myocardial infarction[J].The American Journal of Cardi-ology,2014,113(9):1581-1591.
[16]ROFFI M,PATRONO C,COLLET J P,et al.2015 ESCGuidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation:Task force for the management of acute coronary syndromes in patients presenting without persistent ST-Segment Eleva-tion of the European Society of Cardiology[J].European Heart Journal,2016,37:267-315.
[17]REICHLIN T,HOCHHOLZER W,STELZIG C,et al.Incre-mental value of copeptin for rapid rule out of acute myocardial infarction[J].Journal of the American College of Cardiology,2009,54:60-68.
[18]KELLER T,TZIKAS S,ZELLER T,et al.Copeptin improves early diagnosis of acute myocardial infarction[J].Journal of the American College of Cardiology,2010,55:2096-2106.
[19]CRISTIAN P,MARC A.Copeptin as a diagnostic biomarker for sepsis-related deaths[J].Peptides,2014,59:75-78.
[20]郭文玉,王小庆,邹春霞,等.尾加压素Ⅱ浓度与冠状动脉粥样硬化程度的关系探讨[J].中西医结合心脑血管病杂志,2016,14(8):879-881.
[21]KATAN M,FLURI F,MORGENTHALER N G,et al.Co-peptin:a novel,independent prognosticmarker in patientswith ischemic stroke[J].Annals of Neurology,2009,66(6):799-808.
[22]ENHORNING S,BANKIR L,BOUBY N,et al.Copeptin a marker of vasopressin in abdominal obesity diabetes and mi-croalbuminuria:the prospective Malmo Diet and Cancer Study cardiovascular cohort[J].International Journal of Obesity,2013,37(4):598-603.
[23]MULLER B,MORGENTHALER N,STOLZ D,et al.Circu-lating levels of copeptin,a novel biomarker in lower respira-tory tract infections[J].European Journal of Clinical Investiga-tion,2007,37(2):145-152.
[24]SANG G,DU J M,CHEN J J,et al.Plasma copeptin levels are associated with prognosis of severe acute pancreatitis[J].Peptides,2014,51:4-8.
[25]朱泽磊,王鹏,尤家斌,等.IMA和H-FABP在心源性猝死法医学诊断中的应用[J].法医学杂志,2017,33(4):393-396.
[26]CHAN D,NG L L.Biomarkers in acute myocardial infarction[J].BMC Medicine,2010(8):34.
[2]KEHL D W,IQBAL N,FARD A,et al.Biomarkers in acute myocardial injury[J].Translational Research,2012,159(4):252-264.
[3]KHAN S,DHILLON O,OBRIEN R,et al.C-terminal prova-sopressin(copeptin)as a novel and prognostic marker in acute myocardial infarction:leicester acute myocardial infarction peptide(LAMP)study[J].Circulation,2017,115(16):2103-2110.
[4]刘晓斌,黄子扬.生长分化因子15与心血管疾病[J].中华高血压杂志,2012(3):228-231.
[5]WOLLERT K C,KEMPF T,PETER T,et al.Prognostic value of growth-differentiation factor 15 in patients with nonST-segment elevation acute coronary syndrome[J].Circula-tion,2007,115(8):962-971.
[6]MORGENTHALER N G,STRUCK J,ALONSO C,et al.Assay for the measurement of copeptin,a stable peptide de-rived from the precursor of vasopressin[J].Clinical Chemis-try,2006,5:112-119.
[7]BALANESCU S,KOPP P,GASKILL M B,et al.Correlation of plasma copeptin and vasopress in concentrations in hypoisoand hyperosmolar states[J].Journal of Clinical Endocrinology&Metabolism,2011,96:1046-1052.
[8]CHRIST-CRAIN M,FENSKE W.Copeptin in the diagnosis of vasopressin-dependent disorders of fluid homeostasis[J].Nature Reviews Endocrinology,2016,12:168-176.
[9]BOECKEL J N,OPPERMANN J,ANADOL R,et al.Analyz-ing the release of copeptin from the heart in acute myocardial infarction using a transcoronary gradient model[J].Scientific Reports,2016,6:208-212.
[10]BHANDARI S S,LOKE I,DAVIES J E,et al.Gender and renal function influence plasma levels of copeptin in healthy individuals[J].Clinical Science,2009,116:257-263.
[11]BARAT C,SIMPSON L,BRESLOW E.Properties of human vasopressin precursor constructs:inefficient monomer folding in the absence of copeptin as a potential contributor to diabetes insipidus[J].Biochemistry,2004,45(25):8191-8203.
[12]MUELLER C.Biomarkers and acute coronary syndromes:an update[J].European Heart Journal,2014,35(9):552-556.
[13]REINSTADLER S J,KLUG G,FEISTRITZER H J,et al.Long-term predictive value of copeptin after acutemyocardial infarction:a cardiacmagnetic resonance study[J].International Journal of Cardiology,2014,172(2):359-360.
[14]REINSTADLER S J,KLUG G,FEISTRITZER H J,et al.As-sociation of copeptin with myocardial infarct size and myocar-dial function after ST segment elevation myocardial infarction[J].Heart,2013,99(20):1525-1529.
[15]LIPINSKI M J,ESCARCEGA R O,ASCENZO F D,et al.Asystematic review and collaborative meta-analysis to deter-mine the incremental value of copeptin for rapid rule-out of acute myocardial infarction[J].The American Journal of Cardi-ology,2014,113(9):1581-1591.
[16]ROFFI M,PATRONO C,COLLET J P,et al.2015 ESCGuidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation:Task force for the management of acute coronary syndromes in patients presenting without persistent ST-Segment Eleva-tion of the European Society of Cardiology[J].European Heart Journal,2016,37:267-315.
[17]REICHLIN T,HOCHHOLZER W,STELZIG C,et al.Incre-mental value of copeptin for rapid rule out of acute myocardial infarction[J].Journal of the American College of Cardiology,2009,54:60-68.
[18]KELLER T,TZIKAS S,ZELLER T,et al.Copeptin improves early diagnosis of acute myocardial infarction[J].Journal of the American College of Cardiology,2010,55:2096-2106.
[19]CRISTIAN P,MARC A.Copeptin as a diagnostic biomarker for sepsis-related deaths[J].Peptides,2014,59:75-78.
[20]郭文玉,王小庆,邹春霞,等.尾加压素Ⅱ浓度与冠状动脉粥样硬化程度的关系探讨[J].中西医结合心脑血管病杂志,2016,14(8):879-881.
[21]KATAN M,FLURI F,MORGENTHALER N G,et al.Co-peptin:a novel,independent prognosticmarker in patientswith ischemic stroke[J].Annals of Neurology,2009,66(6):799-808.
[22]ENHORNING S,BANKIR L,BOUBY N,et al.Copeptin a marker of vasopressin in abdominal obesity diabetes and mi-croalbuminuria:the prospective Malmo Diet and Cancer Study cardiovascular cohort[J].International Journal of Obesity,2013,37(4):598-603.
[23]MULLER B,MORGENTHALER N,STOLZ D,et al.Circu-lating levels of copeptin,a novel biomarker in lower respira-tory tract infections[J].European Journal of Clinical Investiga-tion,2007,37(2):145-152.
[24]SANG G,DU J M,CHEN J J,et al.Plasma copeptin levels are associated with prognosis of severe acute pancreatitis[J].Peptides,2014,51:4-8.
[25]朱泽磊,王鹏,尤家斌,等.IMA和H-FABP在心源性猝死法医学诊断中的应用[J].法医学杂志,2017,33(4):393-396.
[26]CHAN D,NG L L.Biomarkers in acute myocardial infarction[J].BMC Medicine,2010(8):34.