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脂肪因子与脂蛋白(A)之间的一种新型联系,以探讨它们在ST段抬高型心肌梗死和非ST段抬高型心肌梗死患者中的诊断作用。

A Novel Link Between Adipokines And Lipoprotein (A) To Contemplate Their Diagnostic Role In Patients With Stemi And Nstemi.

作者信息

Rashid Shazia, Khurshid Rukhshan, Amir Uzma Faryal, Malik Arif, Qazi Sumera

机构信息

CMH Lahore Medical College, Lahore, Pakistan.

Fatima Jinnah Medical University, Lahore, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2017 Jan-Mar;29(1):112-117.

Abstract

BACKGROUND

Early detection of cardiac events allow better and cost-effective triage and welltimed management of these patients. Study was conducted to evaluate the prognostic significance of plasma adiponectin, resistin and lipoprotein (a) in a group of patients with ST segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction. These parameters were also compared with other predictors like troponin T, troponin I and CK-MB.

METHODS

Present study was based on the 100 patients with AMI of whom 52 had a diagnosis of STEMI, and 48 had NSTEMI. Duration of study was January to June 2015. Patients having chest pain that was indicative of myocardial ischemia within first 12 hours after the onset of symptoms were included in the study. Adiponectin, Lp (a), resistin, troponin T and troponin I were estimated using ELISA method. Level of CK-MB was measured by Auto-analyser using standard kit of Merck.

RESULTS

Mean age of patients with STEMI was 52.32 years and with NSTEMI it was 48.17 years. Mean value of BMI of patients with STEMI was 28.33 and with NSTEMI was 25.22 Kg/m2. Duration of chest pain in patients with STEMI was 8.64 and patients with NSTEMI it was 16.52hours with highly significant difference (p<0.001). History of smoking in patients with STEMI was more as compared to the patients with NSTEMI. Level of CPK, adiponectin and lipoprotein (a) was raised in patients with STEMI as compared to patients with NSTEMI but significant difference was only found in levels of CPK (p<0.001) and in adiponectin (p<0.05). Level of serum CK-MB, TnT, TnI and resistin was raised in patients with NSTEMI as compared to patients with STEMI but significant difference (p<0.001) was only observed in serum troponin I concentration.

CONCLUSIONS

It is concluded that the incidence of STEMI and NSTEMI is similar in our patients. However, the markers of STEMI are increased level of adiponectin and Lp(a) and the markers of NSTEMI are troponins especially troponin I, resistin and CKMB.

摘要

背景

早期发现心脏事件有助于对这些患者进行更好且具成本效益的分诊和及时管理。本研究旨在评估一组ST段抬高型心肌梗死和非ST段抬高型心肌梗死患者血浆脂联素、抵抗素和脂蛋白(a)的预后意义。这些参数还与肌钙蛋白T、肌钙蛋白I和肌酸激酶同工酶等其他预测指标进行了比较。

方法

本研究基于100例急性心肌梗死患者,其中52例诊断为ST段抬高型心肌梗死,48例为非ST段抬高型心肌梗死。研究时间为2015年1月至6月。症状发作后12小时内出现提示心肌缺血胸痛的患者纳入研究。采用酶联免疫吸附测定法(ELISA)测定脂联素、脂蛋白(a)、抵抗素、肌钙蛋白T和肌钙蛋白I。使用默克标准试剂盒通过自动分析仪测量肌酸激酶同工酶水平。

结果

ST段抬高型心肌梗死患者的平均年龄为52.32岁,非ST段抬高型心肌梗死患者为48.17岁。ST段抬高型心肌梗死患者的平均体重指数为28.33,非ST段抬高型心肌梗死患者为25.22kg/m²。ST段抬高型心肌梗死患者的胸痛持续时间为8.64小时,非ST段抬高型心肌梗死患者为16.52小时,差异极显著(p<0.001)。与非ST段抬高型心肌梗死患者相比,ST段抬高型心肌梗死患者的吸烟史更多。与非ST段抬高型心肌梗死患者相比,ST段抬高型心肌梗死患者的肌酸磷酸激酶、脂联素和脂蛋白(a)水平升高,但仅肌酸磷酸激酶水平(p<0.001)和脂联素水平(p<0.05)存在显著差异。与ST段抬高型心肌梗死患者相比,非ST段抬高型心肌梗死患者的血清肌酸激酶同工酶、肌钙蛋白T、肌钙蛋白I和抵抗素水平升高,但仅血清肌钙蛋白I浓度存在显著差异(p<0.001)。

结论

得出结论,在我们的患者中,ST段抬高型心肌梗死和非ST段抬高型心肌梗死的发生率相似。然而,ST段抬高型心肌梗死的标志物是脂联素和脂蛋白(a)水平升高,而非ST段抬高型心肌梗死的标志物是肌钙蛋白,尤其是肌钙蛋白I、抵抗素和肌酸激酶同工酶。

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