血清Hcy、cTnT、BNP、甲状腺激素水平在急性心肌梗死患者中的表达及与预后的关系研究

冯宇 王庆蕾

【摘要】 目的：探讨血清同型半胱氨酸（Hcy）、心肌肌钙蛋白T（cTnT）、脑钠肽（BNP）、甲状腺激素水平在急性心肌梗死患者中的表达及其与预后的关系。方法：选取2018年1月-2020年1月本院收治的60例急性心肌梗死患者为研究组，60例健康体检者为对照组。检测两组的血清Hcy、cTnT、BNP、甲状腺激素水平，比较两组血清Hcy、cTnT、BNP、甲状腺激素水平。分析研究组患者APACHEⅡ評分及预后的情况，比较不同APACHEⅡ评分及预后患者的血清Hcy、cTnT、BNP、甲状腺激素水平。结果：研究组Hcy、cTnT、BNP水平均明显高于对照组，TSH、FT3、FT4水平均明显低于对照组，差异均有统计学意义（P<0.05）。随着APACHEⅡ评分的增加，Hcy、cTnT、BNP水平均逐渐增加，TSH、FT3、FT4水平均逐渐降低，差异均有统计学意义（P<0.05）。研究组不同APACHEⅡ评分患者血清Hcy、cTnT、BNP、TSH、FT3、FT4水平比较，差异均有统计学意义（P<0.05）。预后良好者的Hcy、cTnT、BNP水平均明显低于预后不良者，TSH、FT3、FT4均明显高于预后不良者，差异均有统计学意义（P<0.05）。结论：血清Hcy、cTnT、BNP、甲状腺激素水平的检测对急性心梗患者的意义重大，可有效反应疾病的严重程度及预后情况。

【关键词】 同型半胱氨酸 心肌肌钙蛋白T 脑钠肽 甲状腺激素 急性心肌梗死 预后

[Abstract] Objective： To investigate the expression of serum homocysteine （Hcy）， cardiac troponin T （cTnT）， brain naturetic peptide （BNP） and thyroid hormone in patients with acute myocardial infarction and its relationship with prognosis. Method： A total of 60 patients with acute myocardial infarction treated in our hospital from January 2018 to January 2020 were selected as the study group and 60 healthy persons as the control group. Serum Hcy， cTnT， BNP and thyroid hormone levels of the two groups were detected， and serum Hcy， cTnT， BNP and thyroid hormone levels of the two groups were compared. The APACHEⅡ score and prognosis of the study group were analyzed. The levels of serum Hcy， cTnT， BNP and thyroid hormone in patients with different APACHEⅡ score and prognosis were compared in the study group. Result： The levels of Hcy， cTnT and BNP in the study group were significantly higher than those in the control group， while the levels of TSH， FT3 and FT4 were significantly lower than those in the control group， the differences were statistically significant （P<0.05）. With the increase of APACHEⅡ score， the levels of Hcy， cTnT and BNP increased gradually， and the levels of TSH， FT3 and FT4 decreased gradually， the differences were statistically significant （P<0.05）. Comparison of serum Hcy， cTnT， BNP， TSH， FT3 and FT4 levels in patients with different APACHEⅡ scores in the study group， the differences were statistically significant （P<0.05）. The levels of Hcy， cTnT and BNP in patients with good prognosis were significantly lower than those in patients with poor prognosis， and the levels of TSH， FT3 and FT4 were significantly higher than those in patients with poor prognosis， the differences were statistically significant （P<0.05）. Conclusion： The detection of serum Hcy， cTnT， BNP and thyroid hormone levels is of great significance for patients with acute myocardial infarction， and can effectively reflect the severity and prognosis of the disease.

[Key words] Homocysteine Cardiac troponin T Brain natriuretic peptide Thyroid hormone Acute myocardial infarction Prognosis

First-author’s address： The Second Hospital of Chaoyang， Chaoyang 122000， China

doi：10.3969/j.issn.1674-4985.2021.25.030

急性心肌梗死是一種起病急、病死率高的心血管疾病，由于该疾病严重威胁患者的生命安全，因此临床对其重视程度较高[1]。急性心肌梗死的发生主要与冠状动脉粥样硬化有关，发生冠状动脉硬化后，部分心肌会由于较长时间的缺血、缺氧导致局部发生坏死[2]。有研究发现，Hcy、cTnT、BNP及甲状腺激素（TSH、FT3、FT4）的表达在急性心肌梗死患者中呈现异常状态，但对于疾病严重程度与预后的评估研究不足[3-4]。……