摘要目的 探讨血清铁蛋白(serum ferritin,SF)、超敏C反应蛋白(high sensitive C-reactive protein,hsCRP)、肌钙蛋白T(troponin T,TnT)、脑钠肽(B-type natriuretic peptide,BNP)及低密度脂蛋白(low densith lipoprotein,LDL)与急性心肌缺血/再灌注损伤(myocardial ischemia/reperfusion injury,MURI)的关系. 方法 将急性心肌梗死(acute myocardial infarction,AMI)患者按入院后手术时间分为急诊介入组(60例)和择期手术组(60例),选择同期我院正常体检者作为正常对照组(60例).正常对照组患者于体检当天,急诊介入组、择期手术组分别于入院当天及介入术后24 h收集血样,检测血清中SF、hsCRP、TnT、BNP及LDL水平,并检测ST段回落百分比(ST-segment resolution,sumSTR),进行比较分析. 结果 急诊介入组和择期手术组入院时SF、hsCRP、TnT、BNP均高于正常对照组,LDL水平低于正常对照组,差异有统计学意义(P＜0.05);但急诊介入组与择期手术组比较,差异无统计学意义(P＞0.05).急诊介入组术后24 h SF、hsCRP、TnT、BNP及LDL均高于择期手术组,差异有统计学意义(P＜0.05). 结论 AMI急诊介入术后血清中SF、hsCRP、TnT、BNP及LDL均明显变化,联合这几项指标检测对MI/RI的严重程度评估和预防具有重要的临床意义.

abstractsObjective To investigate the relationships between the serum ferritin (SF),high sensitive C-reactive protein (hsCRP),troponin T (TnT),B-type natriuretic peptide (BNP),low density lipoprotein (LDL) and the acute myocardial ischemia/ reperfusion injury (MI/RI).Methods The acute myocardial infarction (AMI) patients were divided into two groups based on the symptom duration:60 emergency intervention operation patients,60 selective operation patients and 60 normal control patients.The levels of SF,hsCRP,TnT,BNP,LDL and the ST-segment resolution (sumSTR) of all the AMI patients were detected at the time of admission and postoperative 24 h,the difference of the two groups were analyzed.Results At the time of admission,the levels of SF,BNP,hsCRP and TnT on the two groups were higher than the normal range,and the level of LDL was lower than the normal range,the difference was statistically significant (P＜0.05),but there were no difference between the two groups (P＞0.05).At postoperative 24 h,the levels of SF,BNP,LDL,hsCRP and TnT on the emergency intervention operation group were higher than the selective operation group,the difference was statistically significant (P＜0.05).Conclusions After emergency intervention,the serum levels of SF,hsCRP,TnT,BNP and LDL in MI/RI were significantly different,all indicators have important significance for evaluating severity of MI/RI and preventing possible relapse.