手术前急性心肌梗死的诊断:高敏肌钙蛋白 T 还是前脑钠尿肽 B 型氨基末端片段?

O. V. Petrova, D. K. Tverdokhlebova, S. Shashin
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摘要

目前,有文献数据表明,B 型前脑钠尿肽的氨基端片段在急性心肌梗死患者的诊断中具有重要意义。研究急性心肌梗死患者术前的原脑钠肽 B 型氨端片段和高敏肌钙蛋白 T 的水平,并评估原脑钠肽 B 型氨端片段在该病症患者中的重要性。我们回顾性分析了 50 例急性心肌梗死患者的病历。对急性心肌梗死患者术前 B 型前脑钠肽氨端片段水平的研究表明,入院时 B 型前脑钠肽氨端片段的值在 127 至 600 pg/ml 之间;与左心室射血分数(r =-0.42,p < 0.05)、急性心力衰竭严重程度(r =+0.57,p < 0.05)和急性心肌梗死预后(r =+0.45,p < 0.05)相关。根据与高敏肌钙蛋白 T 的比较,评估了 B 型前脑钠尿肽氨端片段在急性心肌梗死患者中的价值,结果显示在这种病理情况下将其用作急性心肌细胞损伤的标志物没有任何优势:B 型前脑钠尿肽氨端片段的诊断和预后价值低于高敏肌钙蛋白 T。手术前诊断急性心肌梗死:高敏肌钙蛋白 T 还是前脑钠尿肽 B 型的氨端片段?
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Diagnosis of acute myocardial infarction before surgery: high-sensitivity troponin T or amino-terminal fragment of pro-brain natriuretic peptide type B?
Currently, there are data in the literature about the importance of the aminoterminal fragment of pro-brain natriuretic peptide type B in the diagnosis of patients with acute myocardial infarction.The aim. To study preoperative levels of aminoterminal fragment of pro-brain natriuretic peptide type B and high-sensitivity troponin T in patients with acute myocardial infarction and to assess the significance of aminoterminal fragment of pro-brain natriuretic peptide type B in patients with this pathology.Materials and methods. We retrospectively analyzed 50 medical records of patients diagnosed with acute myocardial infarction.The results. Study of preoperative levels of aminoterminal fragment of pro-brain natriuretic peptide type B in patients with acute myocardial infarction showed that the values of aminoterminal fragment of pro-brain natriuretic peptide type B at hospital admission ranged from 127 to 600 pg/ml; correlated with left ventricular ejection fraction (r =-0,42, p < 0,05), severity of acute heart failure (r =+0,57, p < 0,05), and outcome of acute myocardial infarction (r =+0,45, p < 0,05). Assessment of the value of aminoterminal fragment of pro-brain natriuretic peptide type B in patients with acute myocardial infarction on the basis of comparison with high-sensitivity troponin T revealed no advantages of its use in this pathology as a marker of acute cardiomyocyte damage: aminoterminal fragment of pro-brain natriuretic peptide type B has less diagnostic and prognostic value than high-sensitivity troponin T. Diagnosis of acute myocardial infarction before surgery: highly sensitive troponin T or aminoterminal fragment of pro-brain natriuretic peptide type B?
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