和肽素对合并2型糖尿病的急性心肌梗死患者近期预后的评估价值分析
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摘要
目的探讨和肽素对合并2型糖尿病(type 2 diabetes mellitus,T2DM)的急性心肌梗死(acute myocardial infarction,AMI)患者近期预后的评估价值。方法选取2008年5月—2014年5月我院收治的合并T2DM的AMI患者86例(合并组)、单纯T2DM患者60例(T2DM组)和来我院行体检健康者60例(对照组)作为研究对象,比较3组血清和肽素、脑钠肽(BNP)和胱抑素C(CysC)水平;出院后随访3个月,记录合并组近期预后,分析影响患者预后的相关因素。结果 3组血清和肽素、BNP和CysC水平比较差异有统计学意义(P<0.01),且合并组上述指标水平均显著高于T2DM组和对照组(P<0.01)。合并组患者随访结束时预后良好64例,预后良好率为74.42%,预后不良22例,其中死亡及出现室性心动过速各8例,再发心肌梗死6例。血清和肽素、BNP和CysC水平升高以及Killip分级≥2级为合并T2DM的AMI患者预后不良的独立危险因素。结论合并T2DM的AMI患者血清和肽素水平显著升高,而血清和肽素、BNP和CysC水平升高以及Killip分级≥2级为合并T2DM的AMI患者预后不良的独立危险因素。和肽素可作为预测合并T2DM的AMI患者近期预后的有效指标。
Objective To investigate the evaluation value of Copeptin(CPP) in predicting the short-term prognosis of acute myocardial infarction(AMI) complicated with type 2 diabetes mellitus(T2DM).Methods Eighty-six AMI patients with T2DM(group A),60 patients with T2DM alone(group B),and 60 patients who underwent physical examination in our hospital from May 2008 to May 2014(group C) were selected as study objects.The levels of serum CPP,brain natriuretic peptide(BNP) and serum cystatin C(CysC) were compared between the3 groups.They were all followed up for three months after discharge.The short-term prognosis of group A was recorded and the relevant factors affecting the prognosis of the patients were analyzed.Results Serum CPP,BNP,and CysC levels were significantly different among the 3 groups(P<0.01).The above-mentioned indicators in group A were significantly higher than those in groups B and C(P<0.01).Sixty-four cases with T2DM and AMI had a good prognosis after follow-up,with a favorable prognosis of 74.42%,and 22 cases had a poor prognosis,including 8deaths,8 cases of ventricular tachycardia,and 6 cases of repeated myocardial infarction.Elevated levels of serum CPP,BNP and CysC levels,and Killip grading≥2 were independent predictors of poor prognosis in AMI patients with T2DM.Conclusion Significantly elevated levels of serum CPP,BNP and CysC,Killip grading≥2 are all independent predictors of poor prognosis in AMI patients with T2DM.This suggests that Copeptin can be used as one of the effective indicators for predicting AMI patients with T2DM.
Objective To investigate the evaluation value of Copeptin(CPP) in predicting the short-term prognosis of acute myocardial infarction(AMI) complicated with type 2 diabetes mellitus(T2DM).Methods Eighty-six AMI patients with T2DM(group A),60 patients with T2DM alone(group B),and 60 patients who underwent physical examination in our hospital from May 2008 to May 2014(group C) were selected as study objects.The levels of serum CPP,brain natriuretic peptide(BNP) and serum cystatin C(CysC) were compared between the3 groups.They were all followed up for three months after discharge.The short-term prognosis of group A was recorded and the relevant factors affecting the prognosis of the patients were analyzed.Results Serum CPP,BNP,and CysC levels were significantly different among the 3 groups(P<0.01).The above-mentioned indicators in group A were significantly higher than those in groups B and C(P<0.01).Sixty-four cases with T2DM and AMI had a good prognosis after follow-up,with a favorable prognosis of 74.42%,and 22 cases had a poor prognosis,including 8deaths,8 cases of ventricular tachycardia,and 6 cases of repeated myocardial infarction.Elevated levels of serum CPP,BNP and CysC levels,and Killip grading≥2 were independent predictors of poor prognosis in AMI patients with T2DM.Conclusion Significantly elevated levels of serum CPP,BNP and CysC,Killip grading≥2 are all independent predictors of poor prognosis in AMI patients with T2DM.This suggests that Copeptin can be used as one of the effective indicators for predicting AMI patients with T2DM.
引文
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[8]邓诗武.GDF-15、c TnI、BNP在急性心肌梗死病人中的关系及对其近期预后的预测价值[J].中西医结合心脑血管病杂志,2017,15(18):2294-2296.
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[10]王京娥,陈燕,高山,等.血清簇集蛋白、和肽素和抵抗素检测在2型糖尿病急性脑梗死治疗中的临床意义[J].现代中西医结合杂志,2017,26(29):3257-3259.
[11]黄马玉,冯丽丽.N末端前体B型钠尿肽对预测急性心肌梗死合并糖尿病患者心血管不良事件价值的研究[J].临床内科杂志,2016,33(2):101-103.
[12]薛桦,董秦川,王成太.2型糖尿病合并急性脑梗死的血管损害及临床预后[J].中国综合临床,2016,32(4):299-301.
[13]王新,李春阳,苏立平,等.动脉粥样硬化发病机制及治疗的研究进展[J].实用心脑肺血管病杂志,2017,25(2):1-4.
[14]卢琴.颈动脉粥样硬化超声表现与冠心病的相关性分析[J].数理医药学杂志,2016,29(4):524-525.
[15]张爱萍,柯亨记,佘开儒.阿卡波糖联合二甲双胍对2型糖尿病合并冠心病患者的疗效及预后分析[J].国际泌尿系统杂志,2017,37(6):911-915.
[16]王保功,王学惠,刘华玲.影响老年急性心肌梗死病人PCI术近期预后的相关因素分析[J].中西医结合心脑血管病杂志,2017,15(5):592-596.
[17]Liu H T,Xu Y T,Li H Y,et al.Loss of microR-NA-145 expression is involved in the development and prognosis of breast cancer complicated by type 2diabetes mellitus[J].Int J Biol Markers,2016,31(4):e368-e374.
[18]王春芳,吕高鹏,杨璇,等.治疗前血浆和肽素水平在急性脑梗死患者预后评估中的应用效能[J].山东医药,2017,57(11):69-71.
[19]王德伟,黄洁,杨海英.强化抗血小板治疗对急性心肌梗死合并糖尿病患者的疗效[J].心血管康复医学杂志,2016,24(1):84-87.
[20]陈学,龙静,韩朝辉,等.和肽素脑钠肽及高敏肌钙蛋白T在急性心肌梗死中的早期诊断价值[J].中国急救医学,2016,36(7):634-638.
[21]刘逸群,王怡,周洋,等.股动脉超声及s LRP1、Hcy水平检测在2型糖尿病合并心肌梗死中的应用价值及其相关性[J].中国临床研究,2017,30(2):196-199.
[22]孙菁,南星,黄慧,等.急性冠状动脉综合征合并2型糖尿病患者的临床随访研究[J].疑难病杂志,2017,16(2):109-112.
[23]Stengaard C,Sorensen J T,Ladefoged S A,et al.The potential of optimizing prehospital triage of patients with suspected acute myocardial infarction using high-sensitivity cardiac troponin T and copeptin[J].Biomarkers,2017,22(3-4):351-360.
[24]栾一,李伟,吴立荣,等.急性ST段抬高型心肌梗死合并糖尿病患者的临床特征及预后分析[J].中国介入心脏病学杂志,2018,26(2):87-92.
[2]李秀财,龚敏,金建兰,等.休克指数对2型糖尿病合并急性心肌梗死患者近期预后的判断价值[J].中国医师杂志,2017,19(1):96-97.
[3]郝海荣,张勇,程亮,等.血清和肽素对2型糖尿病肾功能损害的诊断及预后判断的临床意义[J].安徽医药,2016,20(1):106-109.
[4]徐伟豪,郭文杰.糖尿病对急性心肌梗死患者PCI术后远期生存的影响[J].解放军医药杂志,2017,29(3):57-61.
[5]李萌玫,邵一兵,张纯全,等.2型糖尿病血糖控制不良合并急性心肌梗死患者择期经皮冠状动脉介入治疗后冠状动脉微循环及近期预后[J].中国介入心脏病学杂志,2017,25(11):628-633.
[6]徐荣,赵红霞,张虹,等.肥胖抑制素及和肽素预警多囊卵巢综合征患者心血管病变的初步研究[J].中国现代医学杂志,2016,26(6):64-68.
[7]隋希喆,吕田,杨明晖,等.血浆和肽素对急性心肌梗死诊断及预后判断的影响[J].中国老年学杂志,2016,36(7):1610-1612.
[8]邓诗武.GDF-15、c TnI、BNP在急性心肌梗死病人中的关系及对其近期预后的预测价值[J].中西医结合心脑血管病杂志,2017,15(18):2294-2296.
[9]Xu L,Sun H,Wang L F,et al.Long-term prognosis of patients with acute myocardial infarction due to unprotected left main coronary artery disease:a single-Centre experience over 14 years[J].Singapore Med J,2016,57(7):396-400.
[10]王京娥,陈燕,高山,等.血清簇集蛋白、和肽素和抵抗素检测在2型糖尿病急性脑梗死治疗中的临床意义[J].现代中西医结合杂志,2017,26(29):3257-3259.
[11]黄马玉,冯丽丽.N末端前体B型钠尿肽对预测急性心肌梗死合并糖尿病患者心血管不良事件价值的研究[J].临床内科杂志,2016,33(2):101-103.
[12]薛桦,董秦川,王成太.2型糖尿病合并急性脑梗死的血管损害及临床预后[J].中国综合临床,2016,32(4):299-301.
[13]王新,李春阳,苏立平,等.动脉粥样硬化发病机制及治疗的研究进展[J].实用心脑肺血管病杂志,2017,25(2):1-4.
[14]卢琴.颈动脉粥样硬化超声表现与冠心病的相关性分析[J].数理医药学杂志,2016,29(4):524-525.
[15]张爱萍,柯亨记,佘开儒.阿卡波糖联合二甲双胍对2型糖尿病合并冠心病患者的疗效及预后分析[J].国际泌尿系统杂志,2017,37(6):911-915.
[16]王保功,王学惠,刘华玲.影响老年急性心肌梗死病人PCI术近期预后的相关因素分析[J].中西医结合心脑血管病杂志,2017,15(5):592-596.
[17]Liu H T,Xu Y T,Li H Y,et al.Loss of microR-NA-145 expression is involved in the development and prognosis of breast cancer complicated by type 2diabetes mellitus[J].Int J Biol Markers,2016,31(4):e368-e374.
[18]王春芳,吕高鹏,杨璇,等.治疗前血浆和肽素水平在急性脑梗死患者预后评估中的应用效能[J].山东医药,2017,57(11):69-71.
[19]王德伟,黄洁,杨海英.强化抗血小板治疗对急性心肌梗死合并糖尿病患者的疗效[J].心血管康复医学杂志,2016,24(1):84-87.
[20]陈学,龙静,韩朝辉,等.和肽素脑钠肽及高敏肌钙蛋白T在急性心肌梗死中的早期诊断价值[J].中国急救医学,2016,36(7):634-638.
[21]刘逸群,王怡,周洋,等.股动脉超声及s LRP1、Hcy水平检测在2型糖尿病合并心肌梗死中的应用价值及其相关性[J].中国临床研究,2017,30(2):196-199.
[22]孙菁,南星,黄慧,等.急性冠状动脉综合征合并2型糖尿病患者的临床随访研究[J].疑难病杂志,2017,16(2):109-112.
[23]Stengaard C,Sorensen J T,Ladefoged S A,et al.The potential of optimizing prehospital triage of patients with suspected acute myocardial infarction using high-sensitivity cardiac troponin T and copeptin[J].Biomarkers,2017,22(3-4):351-360.
[24]栾一,李伟,吴立荣,等.急性ST段抬高型心肌梗死合并糖尿病患者的临床特征及预后分析[J].中国介入心脏病学杂志,2018,26(2):87-92.