血清NT-proBNP、PT3X与急性心肌梗死合并糖尿病患者预后的相关性研究(1)
【摘要】 目的：探讨血清N-末端脑钠肽前体(NT-proBNP)、长正五聚蛋白3(PTX3)与急性心肌梗死(AMI)合并2型糖尿病(T2DM)患者预后的相关性。方法：选取2018年1月-2019年8月于本院就诊的AMI合并T2DM患者78例为研究组，另选取同期就诊于本院未合并T2DM的AMI患者78例为对照组。比较两组血清NT-proBNP、PT3X水平、主要不良心脏事件(MACE)发生情况，比较研究组中有无MACE发生者的血清NT-proBNP与PT3X水平。结果：研究组血清NT-proBNP与PT3X水平均高于对照组(P<0.05);研究组MACE发生率为41.03%，高于对照组的19.23%(P<0.05);研究组中MACE发生者血清NT-proBNP与PT3X水平均高于无MACE发生者(P<0.05)。结论：与未合并T2DM的AMI患者相比，AMI合并T2DM患者可能存在更为强烈的心肌损害与炎性反应，预后较差，而血清NT-proBNP、PT3X水平与病情严重程度、MACE发生和死亡密切相关，检测两者水平可评估患者病情和预后。
【关键词】 急性心肌梗死 糖尿病 长正五聚蛋白3 N-末端脑钠肽前体
[Abstract] Objective： To investigate the correlation between serum N-terminal pro-B-type natriaretic peptide (NT-proBNP)， pentraxin 3 (PTX3) and the prognosis of patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus (T2DM). Method： A total of 78 patients with AMI and T2DM admitted to our hospital from January 2018 to August 2019 were selected as the study group. And another 78 AMI patients without T2DM admitted to our hospital during the same period were selected as the control group. The levels of NT-proBNP， PT3X and major adverse cardiac events (MACE) in the two groups were compared. The levels of NT-proBNP and PT3X in the patients with or without MACE of the study group were compared. Result： The serum levels of NT-proBNP and PT3X in the study group were higher than those in the control group (P<0.05). The incidence of MACE in the study group was 41.03%， higher than 19.23% in the control group (P<0.05). In the study group， the serum levels of NT-proBNP and PT3X in patients with MACE were higher than those without MACE (P<0.05). Conclusion： Compared with AMI patients without T2DM， patients with AMI and T2DM may have more severe myocardial damage and inflammatory response， and the prognosis is poor. Serum NT-proBNP and PT3X levels are closely related to the severity of the disease， the occurrence of MACE and death， testing both levels can assess the patient’s condition and prognosis.
2型糖尿病(T2DM)屬于代谢性疾病，多由机体胰岛素作用缺陷或胰岛素分泌异常所致，以葡萄糖水平持续增高为主要特征，随着病情发展可诱发其他系统多功能损害，并可引发急性心肌梗死(AMI)等多种严重性并发症[1-3]。AMI是由动脉粥样斑块形成，能够对血小板聚集起到促进作用，并增加其黏附性，促进血栓形成和冠状动脉痉挛，导致血管发生狭窄，降低血流量，诱发严重心血管事件[4]。AMI与T2DM常协同发作，增加原发病治疗难度。长正五聚蛋白3(PTX3)被称为脉管系统的C反应蛋白(CRP)，由白细胞介素-1(IL-1)和肿瘤坏死因子刺激巨噬细胞、血管内皮细胞和成纤维细胞产生，可反映炎症状态[5]。N-末端脑钠肽前体(NT-proBNP)是临床预测AMI的心力衰竭等不良事件发生的标志物。本研究选择2018年1月-2019年8月本院收治的78例AMI合并T2DM患者和78例未合并T2DM的AMI患者为研究对象，旨在分析血清NT-proBNP、PT3X与AMI合并T2DM患者预后的相关性，现报道如下。
1 资料与方法
1.1 一般资料 选取2018年1月-2019年8月本院就诊的78例AMI合并T2DM患者为研究组，另选取同期就诊于本院未合并T2DM的AMI患者78例为对照组。纳入标准：符合《中国2型糖尿病防治指南》中T2DM相关诊断标准[6]，有明确T2DM史正在接受治疗，或任意时间血糖≥11.1 mmol/L、空腹血糖≥7.0 mmol/L;符合《急性心肌梗死诊断和治疗指南》中AMI相关诊断标准[7];认知功能正常;凝血功能正常。排除标准：血液系统疾病;再发AMI;严重肝肾功能损害;急慢性感染;恶性肿瘤;急性外伤;自身免疫性疾病;肥厚性心肌病;甲状腺功能亢进;结缔组织病;急性脑卒中。本研究已经医院伦理委员会批准。, 百拇医药(魏文琦 冯明瑞 廖华 梁妍 郑景文)
【关键词】 急性心肌梗死 糖尿病 长正五聚蛋白3 N-末端脑钠肽前体
[Abstract] Objective： To investigate the correlation between serum N-terminal pro-B-type natriaretic peptide (NT-proBNP)， pentraxin 3 (PTX3) and the prognosis of patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus (T2DM). Method： A total of 78 patients with AMI and T2DM admitted to our hospital from January 2018 to August 2019 were selected as the study group. And another 78 AMI patients without T2DM admitted to our hospital during the same period were selected as the control group. The levels of NT-proBNP， PT3X and major adverse cardiac events (MACE) in the two groups were compared. The levels of NT-proBNP and PT3X in the patients with or without MACE of the study group were compared. Result： The serum levels of NT-proBNP and PT3X in the study group were higher than those in the control group (P<0.05). The incidence of MACE in the study group was 41.03%， higher than 19.23% in the control group (P<0.05). In the study group， the serum levels of NT-proBNP and PT3X in patients with MACE were higher than those without MACE (P<0.05). Conclusion： Compared with AMI patients without T2DM， patients with AMI and T2DM may have more severe myocardial damage and inflammatory response， and the prognosis is poor. Serum NT-proBNP and PT3X levels are closely related to the severity of the disease， the occurrence of MACE and death， testing both levels can assess the patient’s condition and prognosis.
2型糖尿病(T2DM)屬于代谢性疾病，多由机体胰岛素作用缺陷或胰岛素分泌异常所致，以葡萄糖水平持续增高为主要特征，随着病情发展可诱发其他系统多功能损害，并可引发急性心肌梗死(AMI)等多种严重性并发症[1-3]。AMI是由动脉粥样斑块形成，能够对血小板聚集起到促进作用，并增加其黏附性，促进血栓形成和冠状动脉痉挛，导致血管发生狭窄，降低血流量，诱发严重心血管事件[4]。AMI与T2DM常协同发作，增加原发病治疗难度。长正五聚蛋白3(PTX3)被称为脉管系统的C反应蛋白(CRP)，由白细胞介素-1(IL-1)和肿瘤坏死因子刺激巨噬细胞、血管内皮细胞和成纤维细胞产生，可反映炎症状态[5]。N-末端脑钠肽前体(NT-proBNP)是临床预测AMI的心力衰竭等不良事件发生的标志物。本研究选择2018年1月-2019年8月本院收治的78例AMI合并T2DM患者和78例未合并T2DM的AMI患者为研究对象，旨在分析血清NT-proBNP、PT3X与AMI合并T2DM患者预后的相关性，现报道如下。
1 资料与方法
1.1 一般资料 选取2018年1月-2019年8月本院就诊的78例AMI合并T2DM患者为研究组，另选取同期就诊于本院未合并T2DM的AMI患者78例为对照组。纳入标准：符合《中国2型糖尿病防治指南》中T2DM相关诊断标准[6]，有明确T2DM史正在接受治疗，或任意时间血糖≥11.1 mmol/L、空腹血糖≥7.0 mmol/L;符合《急性心肌梗死诊断和治疗指南》中AMI相关诊断标准[7];认知功能正常;凝血功能正常。排除标准：血液系统疾病;再发AMI;严重肝肾功能损害;急慢性感染;恶性肿瘤;急性外伤;自身免疫性疾病;肥厚性心肌病;甲状腺功能亢进;结缔组织病;急性脑卒中。本研究已经医院伦理委员会批准。, 百拇医药(魏文琦 冯明瑞 廖华 梁妍 郑景文)
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