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Objective:To evaluate the correlation between elevated cTnI level and 28-day mortality after liver transplantation.Methods:A retrospective study was conducted in adult patients admitted to ICU after liver transplantation from Jun 2015 to March 2019 at Beijing Chao-Yang Hospital. The cardiac troponin Ⅰ levels within 48 h after surgery were examined. Patients outcome was followed up,the primary end point was mortality within 28-day. Univariate and multivariate logistic regression models were used to look for predictors of 28-day mortality.Results:Three hundred and eighteen patients were included in our analyses. Twenty-six patients died and 292 survived within 28 days after LT. Two hundred and forty-three of 318 (76.4%) cases presented elevated cTnI in the early stage after LT. Thirty-seven of 318 (11.6%) patients presented a moderate elevation of cTnI level (5-10 times over normal upper limit), 75 (23.6%) of them presented severe cTnI elevation (10 times over normal upper limit). Univariate and multivariate logistic regression model shows severe cTnI elevation was the independent prognostic factors associated with 28-day mortality [Odds Ratio (95% confidence interval)=3.151(1.218-8.150), P=0.018]. Conclusion:Early cTnI elevation is common after liver transplantation, and severe cTnI elevation is significantly associated with 28-day mortality.
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Objective To study the early diagnostic value of high-sensitivity cardiac troponin Ⅰ(hs-cTnI) and soluble growth stimulating gene 2 protein (soluble suppression of tumorigenicity 2,sST2) in myocardial injury of acute organophosphorus pesticide poisoning (AOPP).Methods Totally 168 AOPP patients hospitalized from March 2014 to October 2018 were divided into the mild group (n=45),moderate group (n=55) and severe group (n=68).Another 30 healthy persons were served as the control group.The levels of cTnI,hs-cTnI,N-terminal B-type natriuretic peptide(NT-proBNP) and sST2 were detected at 4 h and 12 h after admission.SPSS 21.0 was used for statistical analysis.The measurement data were expressed by mean±standard deviation,two groups were compared by LSD-t test,and the multigroup comparison was made by single factor analysis of variance (ANOVA).The correlation analysis by Spearman correlation test (P＜0.05).Results At 1 h after admission,the hs-cTnI of AOPP patients with different degrees of poisoning was higher than that of control group,and that of severe group was higher than that of mild to moderate group.Comparison between groups was statistically significant (P＜0.05).However,there was no significant difference in the cTnI level (P＞0.05).At 4 h and 12 h after admission,the levels of cTnI and hs-cTnI increased with the increase of poisoning degree and the extension of time,and their level at 12 h after admission were significantly higher than those at 4 h after admission,with statistically significant difference between the two groups (P＜0.05).At 1 h after admission,the level of sST2 in the poisoned patients was higher than that in the control group,and the level in the severe group was higher than that in the mild to moderate groups.At 4 h and 12 h after admission,the level of sST2 was increased significantly,especially in the severe group.The level of sST2 at 12 h after admission was significantly higher than that at 4 h after admission (P＜0.05).The concentration of NT-proBNP was in normal range 1 h after admission,increased gradually at 12 h after admission,and the level of NT-proBNP in the severe group was significantly higher than that in the other groups (P＜0.05),and comparison between the groups was significantly different (P＜0.05).The correlation analysis showed that there was a positive correlation between hs-TnI and sST2 in AOPP patients (r=0.776,P＜0.01).hs-TnI and sST2 was positively correlated with the severity of AOPP (r=0.958,P＜0.01;r=0.844,P＜0.01).That is,the more severe the patient,the higher the concentration of hs-TnI and sST2,and the more serious myocardial injury.Conclusions Early detection ofhs-cTnI and sST2 levels in AOPP patients can identify early myocardial damage and objectively evaluate the extent of myocardial damage.
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Objective To explore the effect of troponin Ⅰ (anti-cTnⅠ) autoantibodies on the quality of life and prognosis in patients with ischemic cardiomyopathy.Methods Patients hospitalized in Henan Provincial People's Hospital for ischemic cardiomyopathy from June 2016 to June 2017 were enrolled.At the same time,physical examiners were selected as the control group.Anti-cTnⅠ autoantibodies were detected in the serum from the patients and control group,which were expressed as the OD value.After six months,all patients were followed up,including death,times of readmission,instrument treatment (CRT-P or CRT-D) or heart transplantation,and quality of life questionnaire (SF-36).The effect of anti-cTnⅠ autoantibodies on the prognosis and quality of life were analyzed.Results In 127 patients with ischemic cardiomyopathy,the OD value of anti-cTnI autoantibodies were significantly higher than that in the control group[(0.55 ± 0.24) vs (0.46 ± 0.07),P＜0.05].With a positive standard of more than 0.67,26 patients with ischemic cardiomyopathy were tested positive for anti-cTnⅠ autoantibodies,with a positive rate of 20.5％.After 6 months of outpatient or telephone follow-up,9 patients were lost to follow-up,and 118 patients were followed up,including 24 patients with positive anti-cTnⅠ autoantibodies.Compared with patients with negative anti-cTnⅠ autoantibodies,the times of readmission in patients with positive anti-cTnⅠ autoantibodies increased significantly[(1.42 ± 0.79)vs (0.30 ± 0.55),P＜0.01] and the physiological function was decreased significantly[(56 ± 19.4) vs (67 ± 20.8),P=0.032].The physiological function,vitality and social function of patients with reduced ejection fraction in the anti-cTnⅠ autoantibodies positive group were significantly worse than those in the anti-cTnI autoantibodies negative group,but there was no significant difference in quality of life between the anti-cTnⅠ autoantibodies positive and negative groups in the patients with preserved and median ejection fraction.Conclusions Patients with ischemic cardiomyopathy of seropositivity for anti-cTnⅠ autoantibodies have worse prognosis and quality of life,especially in those with reduced ejection fraction.
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Objective To investigate the diagnostic value of hypersensitive troponin I (hs-cTnI) , homocysteine (Hcy) , hypersensitive C-reactive protein (hs-CRP) and calcitonin (PCT) detection in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) .Methods Ninety-six patients with AECOPD were enrolled in this study.50healthy subjects were included in the healthy control group.Hs-cTnI was measured by electrochemiluminescence, Hcy level was measured by circulating enzyme method, hs-CRP level was determined by immunoturbidimetry, and colloidal gold blotting was performed.PCT levels, correlation analysis using Pearson correlation analysis, analysis of the correlation between the indicators and AECOPD, using ROC curve analysis of hs-cTnI, Hcy, hs-CRP, PCT diagnosis COPE acute exacerbation curve area (AUC) .Results The levels of hs-cTnI, hs-CRP and PCT in the AECOPD group were higher than those in the healthy control group (P<0.05) .The Hcy in the AECOPD group was lower than that in the healthy control group.The difference was not statistically significant (P>0.05) .Pearson correlation analysis shows that hs-cTnI, hsCRP and PCT were positively correlated with AECOPD (r=0.346, 0.401, 0.509) , and Hcy had a poor correlation with AECOPD (r=0.078) .In the ROC curve analysis, the area under the curve (AUC) for hs-cTnI, hsCRP, and PCT were 0.825, 0.834, and 0.922, respectively, The best diagnostic cut-off values were:0.082, 18.25, 3.075, and the sensitivities were 0.823, 0.802, and 0.781, respectively.The specificities were:0.92, 0.62, and 0.94.Youden′s index was 0.743, 0.422, and 0.721, respectively.The kappa values are:0.699, 0.423, 0.664.Conclusion The detection value of Hcy in the diagnosis of AECOPD is low.The detection of hs-cTnI, hsCRP and PCT has a certain diagnostic value in AECOPD.It can be used as an auxiliary diagnosis index of AECOPD.
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Objective To investigate the relationship between lipoprotein associated phospholipase A2 (Lp－PLA2)and atherosclerotic plaque instability in patients with acute coronary syndrome (ACS),and to provide theoretical basis for diagnosis and treatment of ACS.Methods From September 2015 to February 2016,80 patients with ACS in Shidao People's Hospital of Rongcheng were selected as the study group,including 38 cases in unstable angina group(UAP group),24 cases in non ST segment elevation myocardial infarction group (NSTEMI group), 18 cases in ST segment elevation myocardial infarction group(STEMI group).Forty patients with stable angina pectoris (SAP group)and 40 healthy subjects(healthy group)were selected as control group.Each group was collected 8 hours fasting morning blood sample,the levels of Lp－PLA2,C reactive protein(CRP),troponin Ⅰ,and low density lipoprotein were detected,in order to compare the differences among the groups and the correlation between Lp－PLA2 and ACS plaque instability was analyzed.Results The levels of Lp－PLA2,CRP,troponin Ⅰ and low density lipopro-tein in the ACS group were (312.63 ±11.14)ng/mL,(21.98 ±7.83)mg/L,(0.720 ±0.490)μg/L,(174.76 ± 30.82)mg/dL,respectively,which were significantly higher than those of the healthy group [(141.14 ±12.30)ng/mL, (2.38 ±1.68 )mg/L,(0.010 ±0.003 )μg/L,(79.24 ±17.80 )mg/Ml],and stable angina pectoris group [(176.42 ±12.44)ng/mL,(4.22 ±3.68)mg/L,(0.010 ±0.004)μg/L,(96.54 ±19.41)mg/mL].There were statistically significant differences among all groups(F＝3.07,1.99,2.43,3.25,all P＜0.01).The levels of CRP, Lp－PLA2 and cTnI in ACS patients with different types of the STEMI group,NSTEMI group,UAP group had statisti-cally significant differences,which of the STEMI group were higher than those of the NSTEMI group,which of the NSTEMI group were higher than those of the UAP group(F＝5.15,3.47,2.43,all P＜0.05).Correlation analysis showed that the level of Lp－PLA2 was positively correlated with low density lipoprotein(r＝0.625,P＜0.01)and lipoprotein a(r＝0.532,P＜0.01).logistic regression analysis showed that Lp －PLA2 and CRP were significant independent risk factors of ACS,Lp－PLA2(OR＝1.613,95%CI:1.292 －1.992,P＜0.01),CRP(OR＝1.452, 95%CI:1.210-1.782,P＜0.01).Conclusion Lp－PLA2 is independent risk factor of ACS.Lp－PLA2 is involved in the inflammatory reaction of ACS,and is strongly associated with the stability of atherosclerotic plaque.
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Objective To investigate the effect of Yanhuning injection antiviral therapy in the treatment of acute viral myocarditis patients with Xiedu Qinxin syndrome.Methods From May 2016 to August 2017,84 acute viral myocarditis patients with Xiedu Qinxin syndrome in the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were enrolled in this study.According to the digital table,they were randomly divided into observation group and the control group,with 42 cases in each group.The control group received conventional antiviral therapy,and the observation group was given Yanhuning injection.The heart type free fatty acid binding protein (H－FABP),serum troponin Ⅰ (cTnI),macrophage migration inhibitory factor(MIF)and interleukin 4(IL－4)were measured before and after treatment for 4 weeks.The clinical symptoms score and the effective rate were compared between the two groups at the same time.Results The serum levels of cTnI,H－FABP,MIF and IL－4 of the two groups after treatment were lower than those before treatment(all P＜0.05 ),which of the observation group after treatment were significantly lower than those of the control group (t＝3.012,P＝0.039;t＝2.835,P＝0.040;t＝3.534,P＝0.032;t＝3.323,P＝0.033).The effective rate of the observation group was significantly higher than that of the control group (90.48% vs.80.95%,χ2＝3.432,P＝0.038).The scores of palpitations,sore throat,upsetting the chest tightness of the observation group after treatment were significantly lower than those of the control group (t＝3.045,P＝0.038;t＝2.946,P＝0.039;t＝3.467,P＝0.031;t ＝3.358,P＝0.032).Conclusion Yanhuning injection antiviral therapy in the treatment of acute viral myocarditis patients with Xiedu Qinxin syndrome can signifi-cantly improve the efficacy of patients.
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Objective To explore the clinical effect of Reduning in the treatment of children with herpangina,and its influence on serum creatine kinase (CK),creatine phosphate kinase isoenzyme (CK-MB) activity,CK-MB quality,cardiac troponin Ⅰ (cTnⅠ).Methods 104 children with herpangina were divided into control group and research group according to the draw method,with 52 cases in each group.The control group was given conventional treatment,the research group was treated with Reduning on the basis of conventional treatment.The clinical curative effect,clinical symptoms disappear time,CK,CK-MB activity,CK-MB quality,inflammation factors,immune function before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate of the research group was higher thanthat of the control group (98.07％ vs.84.61％),the difference was statistically significant (P ＜ 0.05).Before treatment,the CK,CK-MB activity,CK-MB quality,cTnⅠ of the two groups had no statistically significant differences (all P ＞ 0.05).After treatment,the CK,CK-MB activity,CK-MB quality,cTnⅠ of the research group were lower than those of the control group [(55.87 ± 6.98) U/L vs.(68.42 ± 8.55) U/L,(22.70 ±2.84)U/L vs.(29.45 ± 3.65)U/L,(2.99 ± 0.37) μg/L vs.(4.48 ±0.56) μg/L,(0.16 ± 0.02) μg/L vs.(0.74 ± 0.09) μg/L],the differences were statistically significant (all P ＜ 0.05).The incidence rate of adverse reaction of the research group was lower than that of the control group,the difference was statistically significant(P＜0.05).Conclusion Theclinical effect of Reduning in the treatment of children with herpangina is sure,it can help to relieve clinical manifestations,reduce serum levels of CK,CK-MB activity,CK-MB quality,cTnⅠ,and can alleviate the body's inflammatory response and immune function.
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Cardiac diastolic dysfunction (CDD)means impaired relaxation and compliance decrease of the heart,resulting a filling dysfunction of left ventricle and even cardiac remodeling.However,the systolic functions are usually normal.At present,original articles of CDD are studied less,but epidemiological studies do showed that the inci-dence of CDD is common in the population,also,CDD showed strong correlation with all cause mortality.Without treat-ment,CDD may progress into diastolic heart failure,recently,as known as heart failure with preserved ejection fraction (HFpEF).Therefore,strengthen the understanding of CDD is significant in decreasing its incidence and improving CDD's prognosis.
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Objective To analyze and deal with false positive results caused by heterophile antibody interference immunoas say.Methods A 65 year old male patient's plasma samples were processed by dilution method,heterophile antibody blockers and tested using different detection systems (Beckman,Siemens and Abbott),respectively.The results obtained by multi plied dilution and different detection systems as well as pre and post-processed by heterophilic antibody blockers were compared and analyzed.Results The Beckman system was used to detect plasma cTnⅠ in patients before dilution and multiplied diluted at 2,4 and 8 times,with the results of 4.60,4.03,3.45 and 2.62 ng/ml,respectively.The cTnⅠ results of the patient's plasma determined by Beckman,Siemens and Abbott system were 4.60,0.023 and 0.022 ng/ml,respectively.The plasma cTnⅠ results of before and after heterophilic antibody blockers processing determined by Beckman system were 4.60 and 0.106 ng/ml respectively.Conclusion This cTnⅠ assay of the patient's plasma was interfered by heterophile antibodies,and altering the detection system or utilizing heterophile antibody blockers can solve such interference effectively.
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Objective To investigate the diagnostic value of N-terminal pro-brain natriuretic peptide(NT-proBNP) and cardiac troponinⅠ (cTnⅠ) in cardiac arrhythmia.And the value of differential diagnosis between different types of arrhythmia.Methods The 114 patients with arrhythmia inpatients diagnosed were collected as the disease group and 108 healthy subjects were collected as the control group in Department of Cardiology,Guizhou Province People's Hospital from May 2016 to April 2017.The serum levels of NT-proBNP and cTnⅠ were detected by chemiluminescence method.All the data were tested for normality and homogeneity of variance.T test was used to compare the serum levels of NT-proBNP and cTnⅠ between patients with arrhythmia and control group.The level of serological differences of NT-ProBNP and cTnⅠ in patients with ventricular premature beats,atrial flutter,atrial fibrillation and ventricular tachycardia were compared by One-way ANOVA.Results There was no significant differences in sex and age between the disease group and the control group (t=0.24,1.47,all P＞ 0.05).Compared with the control group,the serum levels of NT-proBNP (855.96 ± 101.46 pg/ml vs 369.77± 194.88 pg/ml) and cTnⅠ ± 0.43 ng/ml vs 0.037 ± 0.015 ng/ml) were increased,and the serum levels of NT-proBNP and cTnⅠ were significantly higher than those in healthy control group(t=2.29,5.68,all P＜0.05).The serum level of NT-pro BNP in atrial flutter patients(1 427.07 pg / ml) and the serum level of cTnⅠ(2.52 ng/ml) in ventricular tachycardia patients were the highest in premature ventricular contractions,atrial flutter,atrial fibrillation,ventricular tachycardia and other types of arrhythmia.There had different distribution (P＜0.05) of NT-pro BNP and cTnⅠ serum levels among the four kinds of diseases.Conclusion The serum levels of NT-pro BNP and cTnⅠ have some reference value in the diagnosis of arrhythmia and in the differential diagnosis of different types of arrhythmia.
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Objective To investigate the predictive value of serum N-terminal pro brain natriuretic peptide NT-proBNP in left ventricular diastolic dysfunction(LVDD) in septic shock patients.Methods According to retrospective analysis of clinical data 96 patients with septic shock were divided into LVDD group and non-LVDD group.General clinical data,APACHE scores,NT-proBNP,Troponin I(TNI),creatinine,procalcitonin,D-dimer and lactic acid within the first 24 hours after admission were recorded,and multi-factors logistic regression analysis was conducted to find independent risk factors for left ventricular diastolic dysfunction in septic shock patients Receiver operating characteristic curve ROC was constructed to indicate the predictive value.Results There were no significant differences in general clinical data,procalcitonin,D-dimer and lactic acid between two groups.Compared with non-LVDD group the levels of NT-proBNP [lgNT-proBNP (3.66±0.38) vs.(3.03±0.59),P =0.000],TNI [lgTNI(-1.45±0.86)vs.(-2.36±0.82),P ＜ 0.01] and creatinine [(186.12±124.24)vs.(101.16±57.01),P ＜ 0.01] in LVDD group were significantly higher.It was shown by multi-factors logistic regression analysis that NT-proBNP (OR=8.731,95％CI;1.541-49.466,P=0.014) was an independent risk factor for left ventricular diastolic dysfunction in septic shock patients.The area under the curve AUC of NT-proBNP was 0.813 with the cut-off value of 1 725 pg/μL,sensibility =88.6％,specificity =62.1％.Conclusion NT-proBNP was avaluable indicator in predicting left ventricular diastolic dysfunction in septic shock patients.
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Objective Perioperative myocardial infarction remains a severe complication in non-cardiac surgery and is one of the major causes of death.Cardiac troponin (cTn) Ⅰ elevation is associated with short-term and long-term mortality.The aim of the study was to assess the proportion rate of cTnⅠ elevation and its clinical characteristics among patients admitted for orthopaedic surgery with or without cardiovascular events.Methods This is a retrospective study including 27 744 patients aged 50 years or older who admitted for orthopaedic surgery from 2009-2015 in Beijing Jishuitan Hospital.Results Two hundred and sixty-five patients [age (71.7±9.9) years] had cTnⅠ level＞ 0.04 μg/L with 66％ (175 patients) of them being female.Among them,59 patients were isolated troponin rise (ITR) (n=59),13 were preoperative acute myocardial infarction (AMI),and 193 were postoperative AMI.The proportion of postoperative AMI was 0.69％.Those patients were more likely to have a history of coronary artery disease or hypertension.Non-ST-segment elevation myocardial infarction (NSTEMI) was more common (93.3％) than ST-segment elevation myocardial infarction in these patients.Most of them did not experience ischemic symptoms.Totally 76.7％ of the AMI occurred within 3 days of surgery;and the in-hospital mortality rate was 10.4％.Conclusions Perioperative elevation of troponin is common in patients undergoing orthopaedic surgery.Most postoperative AMI were NSTEMI and with absent or atypical ischemia symptoms.Monitoring troponin levels and electrocardiograph in at-risk patients is needed to find most of the AMI.
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Objective To study the relationship between serum levels of visfatin,MMP-2 and MMP-9 in AMI patients.Methods Seventy-five AMI patients served as an AMI group and 60 age-and gender-matched subjects undergoing physical examination served as a control group in this study.Their serum levels of visfatin,MMP-2 and MMP-9 were measured and other biochemical parameters were recorded by ELISA.The relationship of serum levels of visfatin with those of MMP-2,MMP-9,hs-CRP and biochemical parameters was analyzed by Pearson correlation analysis.Results The serum levels of LDL-C,visfatin,MMP-2 MMP-9 and hs-CRP were significantly higher in AMI group than in control group (3.45±0.87 mmol/L vs 2.89±0.65 mmol/L,8.06±2.21 μg/L vs 5.53±1.23 μg/L,150.18 ± 74.58 μg/L vs 64.60±25.86 μg/L,478.77±165.46 μg/L vs 263.54±99.35 μg/L,12.07±2.50 mg/L vs 4.62±1.82 mg/L,P＜0.01).The serum levels of visfatin were positively related with those of MMP-2,MMP-9 and hs-CRP.Conclusion The serum visfatin level is significantly higher in AMI patients,indicating that the serum visfatin level is closely related with the rupture of atherosclerotic plaques and can thus be used as an important marker of unstable atherosclerotic plaques and the rupture of atherosclerotic plaques.
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Objective To study the effect of PCI on left ventricular remodeling,oxidative stress and cardiac function after acute myocardial infarction (AMI).Methods One hundred and sixty-nine AMI patients were divided into PCI group (n=85) and control group (n=84).Their serum cTnⅠ,NT-proBNP,GSH,SOD levels and LVEF were measured,and their symptom and sign scores were recorded after 15 days and 6 months of PCI.Results The serum NT-proBNP level was significantly lower while the LVEF and symptom and sign scores were significantly higher in PCI group than in control group after 6 months of PCI (227.2±52.5 ng/L vs 443.3±59.2 ng/L,44.7％±6.2％ vs 38.2％±5.3％,5.7±1.4 vs 10.4±2.7,P=0.000).The serum cTnⅠ level was significantly lower in PCI group than in control group after 15 days of PCI (1.15±0.29 μg/L vs 2.41±0.36 μg/L,P=0.000).No significant difference was found in SOD and GSH between the two groups (P＞0.05).The readmission rate was 23.53％ and the total effective rate was 94.12％ in PCI group while the readmission rate was 46.43％ and the total effective rate was 71.43％ in control group after 6 months of PCI (P＜0.05).Conclusion PCI can reduce the oxidative stress,reverse the left ventricular remodeling,improve the outcome and reduce the readmission rate in early AMI patients.
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OBJECTIVE:To investigate the protective effects of insulin-glucose on myocardium in patients receiving cardiac valve replacement under cardiopulmonary bypass. METHODS:Totally 120 patients receiving combined cardiac valve replacement under cardiopulmonary bypass were divided into control group and observation group according to random number table,with 60 cases in each group. All patients were given routine operation. Control group was given Thomas cardioplegia and oxygenated blood with a ratio of 1:4(V:V)to protect myocardium at 4 ℃. Besides that,the observation group was additionally given Insulin injec-tion 10 IU/L and Glucose injection 10 g/L added into Thomas cardioplegia at 4 ℃ to protect myocardium. The levels of plasma brain natriuretic peptide(BNP)and cardiac troponinⅠ(cTnⅠ)before anesthesia induction(T0),at the end of cardiopulmonary by-pass(T1),12 h(T2),24 h(T3),48 h(T4),and 72 h(T5)after surgery,the rate of recovery of automatic heartbeat after opening aor-ta,the application of vasoactive agent(dopamine)at T1 and the occurrence of postoperative complications were observed and com-pared between 2 groups. RESULTS:At T0,there was no statistical significance in the levels of plasma BNP and cTnⅠ between 2 groups(P>0.05). The levels of plasma BNP and cTnⅠin 2 groups at T1-5 were significantly higher than T0,with statistical signifi-cance(P0.05). The dos-age of dopamine (at T1) and the incidence of complications in observation group were statistically lower than control group,with statistical significance(P<0.05). No severe ADR was found in 2 groups during or after surgery. CONCLUSIONS:Insulin-glucose can alleviate myocardial damage, reduce the dosage of vasoactive agent and the incidence of postoperative complications in pa-tients receiving combined cardiac valve replacement under cardiopulmonary bypass with significant protective effect on myocardium with good safety.
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Objective To investigate the application value of procalcitonin (PCT),cholinesterase (CHE) and cardiac troponin Ⅰ (cTnⅠ) in the evaluation of disease degree and prognosis of sepsis patients,so as to provide the basis for clinical diagnosis and prognostic evaluation of sepsis.Methods A total of 114 patients with sepsis were selected in Huanggang Central Hospital from May 2014 to June 2016.The patients were divided into sepsis group (n =47),severe sepsis group (n =42) and septic shock group (n =25) according to the severity of the disease.The patients were divided into death group (n =23) and survival group (n =91) according to the survival status.The levels of serum PCT,CHE and cTnⅠ were compared in the groups.Results The levels of serum PCT and cTnI in septic shock group were significantly higher than those in severe sepsis group and sepsis group (P ＜ 0.05).The levels of serum PCT and cTnⅠ in severe sepsis group were significantly higher than those in sepsis group (P ＜ 0.05).The level of serum CHE in septic shock group was significantly lower than that in severe sepsis group and sepsis group (P ＜ 0.05),and the serum CHE level in severe sepsis group was significantly lower than that in sepsis group (P ＜ 0.05).The levels of serum PCT and cTnI in the death group were significantly higher than those in the survival group (P ＜ 0.05),and the serum CHE level in the death group was significantly lower than that in the survival group (P ＜ 0.05).Conclusion The levels of serum PCT,CHE and cTnⅠ are important in evaluating the severity and prognosis of patients with sepsis.
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Objective To study the diagnostic value of serum N-terminal probrain natriutetic peptide (NT-proBNP) level and its influencing factors in very old male heart failure (HF) patients with preserved ejection fraction.Methods Two hundred and thirty-six very old male HF patients with preserved ejection fraction admitted to our hospital from February 2008 to July 2016 were divided into HF group (n=92) and HF-free grup (n=144).Their biochemical parameters were tested and analyzed by correlation analysis.Results The serum NT-proBNP level and logNT-proBNP were significantly higher in HF group than in HF-free group (2205.4±2128.4 ng/L vs 457.3± 312.2 ng/L,P=0.000;3.3±0.3 vs 2.5±0.3,P=0.004).Univariate correlation analysis showed that serum NT-proBNP level was positively related with AF,diuretics,LVEF,left atrium diameter,eGFR,creatinine and logcTnI (P＜0.05,P＜0.01).Multivariate linear regression analysis revealed that AF,LVEF,left atrium diameter,eGFR,and logcTnI were the independent risk factors for NT-proBNP and that NT-proBNP was negatively related with LVEF and eGFR.Conclusion The serum NT-proBNP level in very old male HF patients with preserved ejection fraction can be influenced by a variety of factors.Increasing LVEF and eGFR can reduce their serum NT-proBNP level and improve their outcome.
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Objective To observe the positive rate of serum anti-cardiac troponin Ⅰ autoantibodies (anti-cTnI) in the patients with coronary atherosclerotic heart disease(CHD) and its clinical significance.Methods A total of 200 CHD patients and 200 healthy controls from the Department of Cardiology,Drum Tower Hospital of Nanjing University Medical School during September 2015 and May 2016 were collected in the case-control study.Serum anti-cTnI was detected with an indirect ELISA method.Meanwhile,the general data,chnical biochemical parameters and coronary vascular lesion from the two groups were analyzed.Results The positive rate of anti-cTnI in CHD patients(21/200,10.5％) was significantly higher than that in healthy controls(4/200,2.0％,P ＜ 0.01).According to the detection results of serum anti-cTnI,the participants were divided into three groups,including anti-cTnI positive group with CHD,anti-cTnd negative group with CHD and anti-cTnI positive group in healthy controls.The median age and serum Glu level in the anti-cTnI positive group with CHD were significantly higher than those in the anti-cTnI positive group in healthy controls (P ＜ 0.05),while the levels of serum HDL-C and apoA I were inverse (P ＜ 0.01).The median age and Gensini score in the anti-cTnⅠ positive group with CHD were significantly higher than those in the anti-cTnI negative group with CHD,while the level of serum HDL-C was inverse (P ＜ 0.05).Conclusion Anti-cTnI may be more likely to occur in old CHD patients with severe coronary artery lesions,and the low levels of serum HDL-C and apoA Ⅰ may correlate to the production of anti-cTnⅠ.
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Objective To observe the effects of curcumin on B-type natriuretic peptide (BNP),cardiac troponin Ⅰ (cTnI) and D-dimer in rats with acute pulmonary embolism (APE).Methods The irregular cbemotactic factor (CX3CL1)-shRNA and overexpression vector were designed and synthesized,and adenovirus packages were respectively carried out.Sixty Spargue-Dawley (SD) rats were divided into normal control group,sham-operation group,model group,curcumin group,curcumin+CX3CL1-shRNA group and curcumin+CX3CL1 overexpression vector group by random number table (each group 10 rats).The APE rat models were duplicated by autologous blood embolus method.in the pharmacological intervention groups,1 day and again 40 minutes before operation,a dose of curcumin 100 mg/kg was administered by gavage respectively;in virus intervention groups,3 days before modeling,intravenous injection of 109 pfu into a tail vein was performed once;in sham-operation group and model group,an equivalent dose of normal saline 2 mL daily was administered by gavage;the normal group did not accept any intervention.Six hours after modeling,the change of lung tissue were observed under confocal laser scanning microscope,the lung tissue was taken for hematoxylin-eosin (HE) staining,histopathological changes of lung tissue were observed,and the levels of serum BNP,cTnI,D-dimer were detected by enzyme-linked immunosorbent assay (ELISA).Results Virus infected lung tissue was green,nucler was blue.The HE staining in lung tissue showed:histopathological changes in the model group were more obvious than those in normal group and sham-operation group,after curcumin intervention,some emboli in pulmonary arteries in all treatment groups were partially dissolved,and the inflammation was alleviated.The results of ELISA shows:the contents of cTnI,BNP,D-dimer were significantly higher in model group than those in shamoperation group [cTnI (ng/L):224.97 ± 37.96 vs.149.13 ± 36.65,BNP (ng/L):53.66 ± 21.72 vs.24.62 ± 10.44,D-dimer (ng/L):78.68 ± 13.10 vs.42.00 ± 9.30,all P ＜ 0.05];the contents of cTnI,BNP,D-dimer were significantly lower in curcumin group,curcumin+shRNA group and curcumin+CX3CL1 overexpression vector group than those in model group (cTnI was 162.98 ± 28.65,143.32 ± 34.55,159.50 ± 37.80 vs.204.97 ± 37.96,all P ＜ 0.05,BNP was 27.45 ± 11.00,26.95 ± 6.66,33.05 ± 7.05 vs.53.66 ± 21.72,all P ＜ 0.05,D-dimer was 54.34 ± 4.57,53.38 ± 11.01,56.33 ± 6.80 vs.78.68 ± 13.10,all P ＜ 0.05);there were no statistical significant differences in comparisons among all intervention groups (all P ＞ 0.05).Conclusion Curcumin is able to improve serum BNP,cTnI,D-dimer in APE rats,but its relation with CX3CL1 is not obvious.
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Objective To study the role of nicorandil in protecting myocardium of very old patients with non-ST segment elevation myocardial infarction.Methods Ninety-six very old patients with non-ST segment elevation myocardial infarction admitted to our hospital from March 2012 to July 2016 were randomly divided into experimental group (n=48) and control group (n=48).After 4 weeks of comprehensive treatment,the patients in experimental group were given oral nicorandil (5 mg,3 times a day).The serum cTnI level was measured in 2 groups before treatment and on days 1,3,7 and 10 after treatment.The ECG of 2 groups was observed before and after treatment.Results The serum cTnI level was significantly lower in experimental group than in control group on days 3,7 and 10 after treatment (3.24±4.31 μg/L vs 10.47±t4.72 μg/L,P＜0.05;0.53±0.31 μg/L vs 2.50±1.45 μg/L,P＜0.01;0.09±0.07 μg/L vs O.41±0.26 μg/L,P＜0.01).The ECG was significantly better in experimental group than in control group after treatment (P＜0.05).Conclution Oral nicorandil can protect the myocardium of very old patients with non-ST segment elevation myocardial infarction.