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Objective To evaluate the clinical value of coagulation markers(D-dimer,etc.),myocardial injury markers and blood gas analysis in the risk stratification of PE and prognosis of pulmonary embolism(PE) Methods Totally 201 patients with PE were divided into high-risk group(n=52),intermediate-risk group(n=88),low-risk group(n=61),treatment group(n=67)and 38 normal controls and the level of multiple markers was analyzed. Results DD,Fib,NT-proBNP,PT and PO2of PE patients(high-,intermediate- and low-risk group)were statistically different from those of treatment group and normal controls(P<0.05);cTnⅠ,CK-MB, INR,PTA and RI of high- and intermediate-risk group were statistically different(P < 0.05);but CK and SpO2 were not(P>0.05).Conclusions Multiple markers can be used as a clue to screen high-,intermediate-and low-risk PE.It also could be used to distinguish the prognosis of PE.
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OBJECTIVE:To investigate the effects and safety of fructose sodium diphosphate on cardiac function,myocardial injury markers,ischemia modified albumin (IMA) and copeptin in patients with acute myocardial infarction (AMI).METHODS:In retrospective study,102 AMI patients were collected from Nanyang Second People's Hospital during Feb.2014-Apr.2015,and then divided into observation group and control group according to therapy plan,with 51 cases in each group.Both groups received routine therapy and symptomatic therapy as intravenous dripping of urokinase+ intravenous pump of heparin+oral admin istration of aspirin.Observation group was additionally given fructose sodium diphosphate 10 g intravenously,bid.Treatment courses of 2 groups lasted for 7-10 d.The changes of cardiac function indexes (LVDd,LVSd,LVEF),myocardial injury mark ers (cTn Ⅰ,CK-MB),IMA and copeptin were recorded in 2 groups before and after treatment.The cardiac function grading,the occurrence of ADR and adverse events were also recorded in 2 groups.RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups (P＞0.05).12,24 h after treatment,LVDd and LVSd of 2 groups were shortened significantly,while LVEF and IMA levels were increased significantly,and CK-MB and copeptin levels were decreased significantly,compared to before treatment;the improvement of observation group was significantly better than control group,with statistical significance (P＜0.05).cTn Ⅰ levels of 2 groups were increased gradually compared to before treatment [there was no statistical significance in observation group between 12 h after treatment and before treatment (P＞0.05)];the increase of obser vation group was significantly smaller than that of control group,with statistical significance (P＜0.05).24 h after treatment,the proportion of cardiac function Killip grade Ⅰ-Ⅱ was 96.1％ in observation group,which significantly higher than 78.4％ in control group,with statistical significance (P＜0.05).No severe ADR was found in 2 groups,and there was no statistical significance in the incidence of ADR (P＞0.05).In respect of adverse events,the number of adverse events as severe arrhythmia,re current myocardial infarction,postinfarction angina pectoris and total incidence of ADE in observation group was significantly less or under than control group,with statistical significance (P＜0.05),besides there was no statistical significance in mortality between 2 groups (P＞0.05).CONCLUSIONS:Routine symptomatic treatment combined with sodium fructose diphosphate in the treatment of AMI can effectively increase myocardial injury markers,copeptin and IMA levels,improve cardiac function and reduce the risk of adverse events so as to improve the quality of prognosis.
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Objective To discuss the clinical value of using three markers including ischemia modified albu-min (IMA),N terminal brain natriuretic peptide precursor (NT -proBNP)and allergic troponin I (TnI -Ultra)in diagnosis of acute coronary syndromes (ACS).Methods 80 ACS patients diagnosed by coronary artery imaging were selected,and meanwhile 80 healthy people were chosen as the control group.The serum IMA,NT -proBNP and TnI -Ultra were recorded and compared.The changes of IMA,NT -proBNP and TnI -Ultra in all ACS patients the chest pain onset time,chest pain <3h within and between 3 -6h serum were recorded and compared;And sensitivity,specif-ic and accuracy diagnosis in ACS of the three separate tests and joint detection were compared.Results In ACS patients,serum IMA,NT -proBNP and TnI -Ultra were all significantly higher than those in the control group (t =14.62,25.08,35.77,all P <0.05).In UA,NSTEMI,STEMI patients,serum IMA,NT -proBNP and TnI -Ultra all had statistically significant differences (F =10.89,29.08,40.33,all P <0.05);And in NSTEMI,STEMI patients, serum NT -proBNP and TnI -Ultra were significantly higher than those in patients with UA (all P <0.05 );In STEMII patients,serum NT -proBNP and TnI -Ultra were significantly higher than those in the NSTEMI patients (all P <0.05).In patients chest pain less than 3h,chest pain patients'serum IMA,3 -6h NT -proBNP and TnI -Ultra were significantly higher than those in the control group (all P <0.05);In chest pain less than 3 -6h patients,serum IMA,NT -proBNP and TnI -Ultra were significantly higher than those in chest pain less than 3h patients (all P <0.05).The positive detection rate of IMA,NT -proBNP and TnI -Ultra joint detection was 95.0% (76 /80),which was significantly higher than that of the single detection (P <0.05 ).Conclusion IMA,NT -proBNP and CTnI combined detection could significantly improve the sensitivity and accuracy of the early diagnosis of ACS,which testing cycle is short and easy to operate,worthy of clinical promotion.
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Objective To investigate the diagnostic value and significance of myocardial injury markers in neonates.Methods A retrospective analysis of 838 cases of myocardial injury markers in neonates,the total positive rate of hs -cTnI and the positive rates of hs -cTnI(hypersensitivity cardiac troponin I)in different kinds of neonatal disease were calculated,the levels of abnormalities consistent rate in hs -cTnI and CK -MBmass(creatine kinase MB mass)were compared with hs -cTnI and MYO(Myoglobin).Results The total positive rate of hs -cTnI was 40.33% in the 838 neonates.The highest incidence of myocardial injury was neonatal sepsis (57.14%),followed by neonatal pulmonary hemorrhage (55.56%)and neonatal convulsions (54.55%).The abnormalities consistent rate of hs -cTnI and CK -MBmass was better than hs -cTnI and MYO (85.50% vs 28.11%,χ2 =226.9,P <0.05). Conclusion Neonatal hospitalized children often complicated by myocardial injury;As a biochemical myocardial injury marker,the hs -cTnI detection is important for early detection of myocardial injury,it should be recommend as routine test items;CK -MBmass has better correlation with hs -cTnI than MYO,which can provide guide for doctors to interpret the data of myocardial injury markers.