目的 分析急性心肌梗死(AMI)患者前白蛋白、脑钠肽(BNP)、心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)与短期预后的关系.方法 回顾性分析2015年2月～2016年6月于解放军第九五医院心内科收治的61例AMI患者资料,男性29例,女性32例,年龄38～78岁,平均(56.14±5.76)岁.按治疗后30 d内心脏不良事件发生情况,分为发生组(10例)与未发生组(51例).入院后检测前白蛋白、BNP、cTnT、CK-MB水平.收集患者住院的一般资料,随访观察治疗后30 d内心脏不良事件发生情况.结果 与未发生组比较,发生组年龄、BNP、cTnT、CK-MB显著升高,糖尿病比例增加,心功能降低,差异有统计学意义(P均<0.05).多因素分析结果显示,年龄(OR=2.680,95％CI:1.186～6.058)、糖尿病(OR=2.372,95％CI:1.161～4.822)、心功能分级(OR=3.364,95％CI:1.233～9.172)、BNP(OR=1.980,95％CI:1.125～3.483)、cTnT(OR=1.532,95％CI:1.077～2.352)为AMI患者预后不良的独立危险因素(P均<0.05).结论 BNP、cTnT、CK-MB为AMI患者短期预后不良的影响因素,而前白蛋白与预后无明显相关.%Objective To analyze the relationship among prealbumin (PAB), brain natriuretic peptide (BNP), cardiac troponin T (cTnT), creatine kinase-MB isoenzyme (CK-MB) and short-term prognosis in patients with acute myocardial infarction (AMI).Methods AMI patients (n=61, male 29, female 32, aged from 38 to 78 and average age=56.14±5.76) were chosen from the Department of Cardiology of Chinese PLA 95th Hospital from Feb. 2015 to June 2016. The patients were divided, according to occurrence of major adverse cardiovascular events (MACE), into MACE group (n=10) and non-MACE group (n=51). The levels of PAB, BNP, cTnT and CK-MB were detected after hospitalization. The general data was collected from the patients, and occurrence of MACE was followed up and observed within 30 d after treatment. Results Compared with non-MACE group, age, BNP, cTnT and CK-MB increased significantly, percentage of diabetic cases increased, and heart function decreased in MACE group (allP<0.05). The results of multi-factor analysis showed that age (OR=2.680, 95％CI: 1.186～6.058), diabetes (OR=2.372, 95％CI: 1.161～4.822), NYHA grading (OR=3.364, 95％CI: 1.233～9.172), BNP (OR=1.980, 95％CI: 1.125～3.483) and cTnT (OR=1.532, 95％CI: 1.077～2.352) were independent risk factors of poor prognosis in AMI patients.Conclusion BNP, cTnT and CK-MB are influence factors of poor short-term prognosis, and PAB is not significantly correlated with prognosis in AMI patients.
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