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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
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殷云杰,翁嘉懿,徐亮,陈燕春.N末端脑钠肽前体、超敏C-反应蛋白和血清CD137对急性心肌梗死患者左心室重构的预测价值[J].中华老年多器官疾病杂志,2020,19(7):530~534
N末端脑钠肽前体、超敏C-反应蛋白和血清CD137对急性心肌梗死患者左心室重构的预测价值
Predictive value of N-terminal pro-B-type natriuretic peptide, high-sensitivity C-reactive protein and serum CD137 in left ventricular remodeling among patients with acute myocardial infarction
投稿时间:2019-08-19  
DOI:10.11915/j.issn.1671-5403.2020.07.125
中文关键词:  N末端脑钠肽前体;超敏C-反应蛋白;白细胞分化抗原137;急性心肌梗死;心室重构
英文关键词:N-terminal pro-B-type natriuretic peptide; high-sensitivity C-reactive protein; cluster of differentiation 137; acute myocardial infarction; ventricular remodeling This work was supported by the Youth Project of Wuxi Health and Family Planning Commission
基金项目:无锡市卫计委青年项目(Q201752);苏州市“科教兴卫”青年科技项目(KJXW2017040)
作者单位E-mail
殷云杰 宜兴市人民医院心血管内科,江苏 宜兴 214200 staff890@yxph.compredictive 
翁嘉懿 南京医科大学附属苏州医院心血管内科,江苏 苏州 215008 staff890@yxph.compredictive 
徐亮 宜兴市人民医院心血管内科,江苏 宜兴 214200 staff890@yxph.compredictive 
陈燕春 宜兴市人民医院心血管内科,江苏 宜兴 214200 staff890@yxph.compredictive 
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中文摘要:
      目的 探讨急性心肌梗死(AMI)患者N末端脑钠肽前体(NT-proBNP)、超敏C-反应蛋白(hs-CRP)和血清白细胞分化抗原137(CD137)的表达及其与左心室重构(LVR)的关系。方法 选择2017年1月至2018年5月于宜兴市人民医院心血管内科确诊为急性心肌梗死的住院患者124例,入院常规检测血常规、生化、心肌酶、血清肌钙蛋白T(cTNT)、NT-proBNP、hs-CRP、血清CD137等指标,入院期间及出院12个月行超声心动图检查。随访12个月后根据是否存在LVR分为LVR组(n=38)和非LVR组(n=86)。采用SPSS 16.0统计软件进行数据分析。相关性分析采用Pearson相关分析法。采用多因素二分类logistic回归法分析LVR的独立危险因素。采用受试者工作特征(ROC)曲线评估NT-proBNP、hs-CRP、血清CD137对LVR的预测价值。结果 LVR组患者入院时NT-proBNP、hs-CRP、血清CD137均明显高于非LVR组,差异具有统计学意义(P<0.05)。Pearson相关分析表明,NT-proBNP(r=0.419)、hs-CRP(r=0.209)和血清CD137(r=0.604)水平与左心室舒张期末内径增加值呈正相关(均P<0.05)。二分类logistic 回归分析显示,NT-proBNP、hs-CRP和血清CD137水平是AMI后发生LVR的独立危险因素(P<0.05)。NT-proBNP、hs-CRP和血清CD137水平预测LVR发生的ROC曲线下面积(AUC)分别为0.753,0.722,0.690,三者联合预测的AUC为0.805(均P<0.05)。结论 NT-proBNP、hs-CRP和血清CD137水平与急性心肌梗死后LVR密切相关,三者联合检测对急性心肌梗死后LVR有一定的预测价值。
英文摘要:
      Objective To investigate the expression levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP) and cluster of differentiation 137 (CD137) in patients with acute myocardial infarction and their relationship with left ventricular remodeling (LVR). Methods A total of 124 hospitalized patients diagnosed with acute myocardial infarction were recruited from the Department of Cardiology of Yixing People′s Hospital from January 2017 to May 2018. Blood routine indicators, biochemical indicators, myocardial enzymes, serum troponin T (cTNT), NT-proBNP, hs-CRP and serum CD137 were routinely detected at admission, and echocardiography was performed during hospitalization and in 12 months after discharge. According to the results of echocardiography in 12 months′ follow-up, the patients were divided into LVR group (n=38) and non-LVR group (n=86). SPSS statistics 16.0 was used for data analysis. Pearson correlation analysis was applied for correlation analysis. Multivariate binary logistic regression analysis was used to analyze the independent risk factors of LVR, and receiver operating characteristic (ROC) curve was employed to evaluate the predictive value of NT-proBNP, hs-CRP and serum CD137 for LVR. Results NT-proBNP, hs-CRP and serum CD137 in the LVR group were significantly higher than those in non-LVR group at admission (P<0.05). Pearson correlation analysis showed that NT-proBNP (r=0.419), hs-CRP (r=0.209) and serum CD137 (r=0.604) were positively correlated with the increase of left ventricular end-diastolic diameter (all P<0.05). Binary logistic regressionanalysis showed that NT-proBNP, hs-CRP and serum CD137 levels were independent risk factors for LVR after acute myocardial infarction (P<0.05). The area under the ROC curve (AUC) of NT-proBNP, hs-CRP and serum CD137 levels in prediction of LVR occurrence was 0.753,0.722 and 0.690, respectively, and the AUC of the combined prediction of the 3 indicators was 0.805 (all P<0.05). Conclusion NT-proBNP, hs-CRP and serum CD137 levels are closely associated with LVR after acute myocardial infarction. The combined detection of them may be of certain predictive value for LVR.
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