Objective To discuss the relationship among procalcitonin (PCT), cardiac troponin I (cTnI), N-terminal pro-brain natriuretic peptide (NT-proBNP) and short-term prognosis in patients with acute myocardial infarction (AMI). Methods The patients with diagnosed AMI (n=182, male 117, female 65, aged from 46 to 80 and average age=60.89±7.22) were chosen from the Department of Cardiology of Anqing Municipal Hospital affiliated to Anhui Medical University from July 2014 to Dec. 2016, and their clinical materials were retrospectively analyzed. After discharged from the hospital, all patients were followed up by outpatient department, telephone or e-mail for 1 y, and then divided, according to whether or not they had major adverse cardiovascular events (MACE), into MACE group (n=59) and non-MACE group (n=123). The general data and detection results of PCT, cTnI and NT-proBNP were collected. The predictive values of all indexes to MACE were reviewed by using receiver operating characteristic curve (ROC). Results The levels of cTnI, PCT and NT-proBNP were all higher in MACE group than those in non-MACE group (all P<0.05). The results of RCO analysis showed that the sensitivity of PCT, cTnI and NT-proBNP for predicting MACE was, respectively, 87.6%, 92.3% and 94.7%, specificity was, respectively, 77.1%, 78.6% and 83.5%, and the best diagnostic node was, respectively, 0.0986 ng/mL, 1.027 μg/L and 569.34 pg/mL. The results of Logistic regression analysis showed that PCT (OR=1.353, 95%CI: 1.045~1.589), NT-proBNP (OR=1.646, 95%CI: 1.165~2.179) and cTnI (OR=1.946, 95%CI: 1.294~2.584) were influence factors of MACE in AMI patient. Conclusion The levels of PCT, cTnI and NT-proBNP are correlated to short-term prognosis and can provide reference for prognosis review in AMI patients.%目的 探究降钙素原(PCT)、心肌肌钙蛋白I(cTnI)、N末端脑钠肽前体(NT-proBNP)与急性心肌梗死患者短期预后的关系.方法 回顾性分析2014年7月~2016年12月于安徽医科大学附属安庆医院心内科确诊的182例急性心肌梗死患者的临床资料,男性117例,女性65例,年龄46~80岁,平均年龄(60.89±7.22)岁.出院后门诊、电话或邮件随访1年,根据患者是否出现主要不良心血管事件(MACE)分为MACE组(59例)和非MACE组(123例).收集患者一般资料以及入院时PCT、cTnI、NT-proBNP的检测结果.应用受试者工作特征曲线(ROC)评估各指标的MACE预测价值.结果 MACE组的cTnI、PCT及NT-proBNP均高于非MACE组,差异有统计学意义(P均<0.05).经ROC曲线分析,血清PCT、cTnI、NT-proBNP预测急性心肌梗死患者发生MACE的敏感性分别为87.6%、92.3%、94.7%,特异性分别为77.1%、78.6%、83.5%,最佳诊断节点分别为0.0986 ng/ml、1.027 μg/L、569.34 pg/ml.经多因素Logistic回归分析,PCT(OR=1.353,95%CI:1.045~1.589)、NT-proBNP(OR=1.646,95%CI:1.165~2.179)、cTnI (OR=1.946,95%CI:1.294~2.584)是急性心肌梗死患者发生MACE的影响因素.结论 PCT、cTnI、NT-proBNP水平与急性心肌梗死患者短期预后相关,为急性心肌梗死患者预后评估提供参考.
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