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目的探讨急性心肌梗死(AMI)患者血液中心脏型脂肪酸结合蛋白(H-FABP)、N-末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)的水平与AMI后室壁瘤(LVA)形成之间的关系。方法2009年1月—2013年2月诊治AMI患者67例,根据有无LVA形成分为LVA组35例,无LVA组32例。AMI发病后12 h内检测患者血液H-FABP、NT-proBNP、cTnI,同时左室造影(LVG)检测左室收缩末期容积指数(LVESVI)和左室舒张末期容积指数(LVEDVI)、左室舒张末期压(LVEDP)、左室射血分数(LVEF)及室壁运动指数(WMS)。并分析心脏造影各参数与血生化指标的相关性。结果LVA组Ki1lip III级患者占10例(28.57%),无LVA组占1例(3.13%),2组比较差异有统计学意义(P<0.01)。无LVA组患者血浆H-FABP、NT-proBNP、cTnI水平显著低于LVA组患者(P<0.05或P<0.01);心脏造影各参数显著优于LVA组患者(P<0.05)。血浆H-FABP、NT-proBNP、cTnI水平与心脏造影各参数(LVESVI、LVEDI、WMS、LVEDP)具有较高的相关性(P<0.05,P<0.01)。结论AMI发病后LVA形成患者血浆HFABP、NT-proBNP、cTnI水平升高,其可较好地提示AMI发病后LVA的形成。
Objective To investigate the changes of blood levels of cardiac-specific fatty acid-binding protein (H-FABP), NT-proBNP and cTnI in patients with acute myocardial infarction (AMI) The relationship between the formation of the wall tumor (LVA). Methods From January 2009 to February 2013, 67 patients with AMI were diagnosed and treated with LVA. According to the presence or absence of LVA, 35 patients were divided into LVA group and 32 patients without LVA group. The left ventricular end-systolic volume index (LVESVI) and left ventricular end-diastolic volume index (LVEDVI), left ventricular diastolic function (LVEDVI), left ventricular diastolic volume LVEDP, LVEF and WMS. And analyze the correlation between the parameters of cardiac angiography and blood biochemical indicators. Results There were 10 cases (28.57%) of Ki1lip class III patients in LVA group and 1 case (3.13%) in non-LVA group. There was significant difference between the two groups (P <0.01). The plasma levels of H-FABP, NT-proBNP and cTnI in patients without LVA were significantly lower than those in patients with LVA (P <0.05 or P <0.01). The parameters of cardiac imaging were significantly better than those in patients with LVA (P <0.05). The plasma levels of H-FABP, NT-proBNP and cTnI had a higher correlation with LVCA, LVEDI, WMS and LVEDP (P <0.05, P <0.01). Conclusions The plasma levels of HFABP, NT-proBNP and cTnI in patients with LVA are higher after AMI onset, which may be a good indicator of the formation of LVA after AMI.