【摘要】 目的研究ST段抬高性急性心肌梗死(STEAMI)患者的血浆和肽素浓度对其住院期间主要不良心脏事件(MACE)的预测价值。方法纳入STEAMI患者和健康体检者(对照组)各102例,对照组静脉血体检时获得,STEAMI患者静脉血在入院时获得。血浆和肽素浓度用酶联免疫吸附测定法检测。结果 STEAMI组血浆和肽素浓度(539±294)pg/ml显著高于对照组(57±24)pg/m(lt=16.323,P<0.001)。Logistic回归分析显示,血和肽素浓度(OR=1.008,95%CI=1.004～1.011,P<0.001)和血心肌肌钙蛋白Ⅰ(cardiactroponinⅠ,cTnⅠ)浓度(OR=16.271,95%CI=2.423～109.282,P=0.004)是STEAMI患者住院期间MACE的独立危险因素。受试者工作特征(ROC)曲线分析显示,血浆和肽素浓度(ROC曲线下面积(AUC)=0.887,95%CI=0.809～0.941)和cTnⅠ浓度(AUC=0.711,95%CI=0.613～0.796)对STEAMI患者住院期间发生的MACE均有显著预测价值,而血浆和肽素浓度ROC曲线下面积显著大于cTnⅠ浓度(z=2.392,P=0.017)。结论 STEAMI患者血浆和肽素浓度显著升高,故检测该指标有助于临床早期预测STEAMI患者住院期间MACE的发生。更多还原

【Abstract】 Objective To investigate the predictive value of copeptin levels in patients with ST-segment elevation acute myocardial infarction (STEAMI) for in-hospital major adverse cardiac event (MACE). Methods One hundred and two consecutive patients with STEAMI and 102 matched healthy controls were enrolled in the study. Plasma samples were obtained on entry in healthy controls, as well as on admission in patients with STEAMI. The copeptin concentration of all the cases were determined by enzyme-linked immunosorbent assay (ELISA). Results Plasma copeptin levels remarkably increased in patients with STEAMI compared with healthy controls (t = 16.323, P < 0.001). In logistic regression analysis, the plasma copeptin (OR = 1.008, 95% CI = 1.004 ~ 1.011, P < 0.001) and serum troponinⅠ(cTnⅠ) (OR = 16.271, 95% CI = 2.423 ~ 109.282, P = 0.004) were identified as independent risk factors for in-hospital MACE in the patients with STEAMI. Receiver operating characteristic curve (ROC) analysis revealed that copeptin and cTnⅠrendered valuable with an area under the ROC (AUC) of 0.887 (95% CI = 0.809 ~ 0.941) and 0.711(95% CI = 0.613 ~ 0.796) for in-hospital MACE in the patients with STEAMI, while the AUC was significantly higher for copeptin than for cTnⅠ(z = 2.392, P = 0.017). Conclusion The elevated plasma copeptin concentration may be an early prognostic marker for in-hospital MACE in the patients with STEAMI.更多还原