Hs-cTnT和H-FABP在慢阻肺急性加重期心脏功能早期损害中的临床意义

发布时间：2018-03-09 23:06

本文选题：肺疾病　切入点：慢性阻塞性　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的通过检测慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗前后血清高敏肌钙蛋白T(hs-c Tn T)、心型脂肪酸结合蛋白(H-FABP)表达水平的变化,探讨它们在AECOPD患者心脏功能早期损害中的临床意义。方法对2015年12月至2016年6月我科110例慢性阻塞性肺疾病急性加重期住院患者进行研究,符合入组条件患者80例,其中轻、中度组35例、重度、极重度组45例,同期40例门诊体检者为对照组。收集一般临床资料,分别采用电化学发光法测定血清hs-c Tn T、酶联免疫吸附法测定血清H-FABP,并进行动脉血气、血清AST、LDH、CK、CKMB、c Tn I、肌红蛋白测定,所有受试者进行肺功能检查。比较分析各组间一般资料及血清学心肌损伤指标。同时,所有AECOPD患者依据GOLD2015年指南推荐,均接受正规内科治疗,AECOPD患者病情稳定状态下对其进行上述相关指标的复测。结果与对照组相比,AECOPD组hs-c Tn T及H-FABP的表达量均显著增高(P0.001);与治疗前相比,轻、中度AECOPD组治疗后hs-c Tn T表达量轻度降低,差异无统计学意义(P0.05),H-FABP表达量显著降低,差异具有统计学意义(P0.01);重、极重度AECOPD组治疗后的hs-c Tn T和H-FABP表达量较治疗前均显著降低,差异有统计学意义(P0.01);c Tn I、AST、LDH、CK、CKMB、肌红蛋白表达量于治疗前后比较均无统计学意义(P0.05)。结论与传统的心肌指标相比较,血清hs-c Tn T和H-FABP对于早期判断AECOPD患者心肌损伤可能具有重要的临床价值,对进行早期临床干预具有指导意义。
[Abstract]:Objective to investigate the changes of serum troponin TnTn and cardiac fatty acid binding protein (H-FABP) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) before and after treatment. Methods from December 2015 to June 2016, 110 inpatients with acute exacerbation of chronic obstructive pulmonary disease (COPD) in our department were studied. 35 cases in moderate group, 45 cases in severe group, 45 cases in severe group and 40 cases in outpatient examination group as control group. General clinical data were collected, serum hs-c TN T was measured by electrochemiluminescence method, serum H-FABP was measured by enzyme-linked immunosorbent assay (Elisa), and arterial blood gas was performed. Serum ASTX LDHK CKMBC T n I, myoglobin, pulmonary function tests were performed in all subjects. General data and serum myocardial injury indexes were compared and analyzed among the groups. Meanwhile, all AECOPD patients were recommended according to the GOLD2015 year guidelines. Results the expression of hs-c TNT and H-FABP in AECOPD group was significantly higher than that in control group (P 0.001). After treatment, the expression of hs-c TNT and H-FABP in moderate AECOPD group was slightly decreased, but there was no significant difference in the expression of H-FABP between the two groups (P 0.05), the difference was statistically significant (P 0.01), the expression of hs-c TNT and H-FABP in very severe AECOPD group was significantly lower than that before treatment, and the expression of TnT and H-FABP in severe AECOPD group was significantly lower than that before treatment. The difference was statistically significant (P 0.01). The expression of myoglobin was not significantly different between before and after treatment. Conclusion compared with the traditional myocardial indexes, the expression of myoglobin in CKMBs was not significantly different from that of the traditional myocardial indexes, and there was no significant difference in the expression of myoglobin between the two groups before and after treatment. Serum hs-c TNT and H-FABP may have important clinical value in early diagnosis of myocardial injury in patients with AECOPD, and have guiding significance for early clinical intervention.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9

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