ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
Objective To evaluate the myocardial protective effects of Histidine-TryptophanKetoglutarate (HTK) solution on infants with tetralogy of fallot in cardiac operation through comparison with St.Thomas Ⅱ cardioplegia(STH) and HTK cardioplegia in the operation of tetralogy of fallot.Methods Forty infants with tetralogy of fallot(TOF) were enrolled in this study.Their age ranged from 7 to 35 months,and body mass from 5.3 to 9.5 kg.The infants were randomly divided into HTK (n =20) group and STH (n =20) group who received HTK or STH solution respectively.Then 3 ml blood sample were got at 1,2,4,8,24 and 48 h after the opening of ascending aorta.The serum levels of cardiac troponin Ⅰ(cTnI),creatine kinase(CK) and creatine kinase MB(CK-MB) were measured.Results There was significant difference between two groups in terms of the level of cTnI at different time (F(inner group)=49.94,P＜0.001;F(between group) =10.23,P＜0.001;F (across group) =28.49,P＜0.001),and the level of cTnI in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK at different time (F(inner group) =58.85,P＜0.001;F(between group) =16.43,P＜0.001;F(across group)=18.32,P＜0.001),and the level of CK in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK-MB at different time (F(inner group)=34.51,P ＜0.001;F(between group)=11.03,P＜0.001;F(across group)=10.28,P＜0.001),and the level of CK-MB in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P ＜0.05).Conclusion HTK is more valid than STK for improving the ability of anti ischemia of myocardium and cardiac function,reducing arrhythmia and ischemia reperfusion injury on infants with TOF in cardiopulmonary bypass.
ABSTRACT
OBJECTIVE:To investigate the protective effects of adjunctive general anesthesia of dexmedetomidine on cardiac and cerebral ischemia-perfusion injury. METHODS:50 patients,ASA physical status Ⅰ-Ⅱ,undergoing selective tracheal intuba-tion,were randomly divided into dexmedetomidine group (group D) and control group (group C) with 25 cases in each group. The patients in group D received a loading dose of 1 μg/kg of dexmedetomidine by infusion pump before anaesthesia,10 min lat-er by a maintenance dose of 0.5 μg/(kg·h)till the end of surgery;whereas patients in group C received normal saline and same induction. HR,SBP and DBP of 2 groups were monitored at the beginning of operation,10 min after incision,30 min after inci-sion,at the end of operation. Blood samples of vena jugularis interna were taken to determine the plasma levels of cardiac tropo-ninⅠ(cTnⅠ) ,adrenaline and norepinephrine before anesthesia induction (T0),at the end of surgery (T1),6 h after surgery (T2),12 h after surgery(T3),24 h after surgery(T4),48 h after surgery(T5). RESULTS:There was no statistical significance in the levels of HR,SBP and DBP in group D between during operation and at the beginning of operation(P>0.05);those in-dex were significantly lower than those of group C at corresponding time points,with statistical significance(P<0.05). The lev-els of cTnⅠ in group D at T2-T5 were significantly lower than in group C,with statistical significance(P<0.05). The levels of adrenaline and norepinephrine at T1-T5 were significantly lower than group C,with statistical significance (P<0.05). CONCLU-SIONS:Adjunctive general anesthesia of dexmedetomidline can improve cardiac and cerebral ischemia-perfusion injury to certain extent.
ABSTRACT
Objective To provide a reasonable clinical evidence and testing index for acute myocardial infarction (AMI) early diagnosis by investigating the levels of serum ischemia-modified album(IMA),cardiac troponin I(cTnI) and high-sensitivity C-reactive protein (hs-CRP) in patients with AMI.Methods 66 cases with AMI were divided into two groups by the time of starting attack chest pain to clinic,the time of 0-4h as E group (39 cases),4-8h as F group (27 cases),another 59 healthy persons in the control group were detected.Then collected serum samples from each case to detect the concentration of the IMA,cTnI and hs-CRP.Results The levels of serum IMA,cTnI and hs-CRP in E group were significantly higher than those in the control group( P ＜ 0.05 or P ＜ 0.001 ),in addition to the IMA level was higher than normal,cTnI and hs-CRP levels were in the normal range.The levels of serum IMA,cTnI and hs-CRP in F group were significantly higher than the levels of control group( P ＜0.05 ) and also above the normal.Conclusion IMA,cTnI and hs-CRP not only can be used as the effective index for AMI early diagnosis,but also help for early diagnosis.The results provide a reliable basis for disease treatment and condition development.
ABSTRACT
Objective To investigate the impacts of carvedilol combined with pravastatin,on aminoterminal pro-brain natriuretic peptide(NT-proNBP),cardiac troponin Ⅰ(cTnI)and cardiac function in coronary heart disease patients with chronic heart failure.Methods One hundred and tewnty five cases of coronary heart disease patients with chronic heart failure were randomly divided into the carvedilol group(63 cases)and carvedilol combined with pravastatin group(62 cases).In addition to using certain dosage of the above-mentioned drugs respectively,both groups underwent routine anti heart failure treatment with the course of 12 weeks.The class of heart function and changes of heart rate(HR) were observed before and after treatment.Left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD) and left ventricular ejection fraction(LVEF) were determined by using ultrasound heartbeat graph.Six min walk test(6MWT)was also observed before and after treatment and the level of NT-proBNP and cTnI level were determined by using an enzyme immunoassay method.And patients readmission rates and the incidence of cardiovascular events were also observed.Results The condition of carvedilol and pravastatin group were improved after treatment compared with before treatment[HR:(78±12) CICCS/min vs(100±112) CICCS/min,t =13.682,P ＜ 0.05 ;LVEDD:(43±5)mmvs(53±8)mm,t=5.284,P＜0.01;LVESD:(42±6)mmvs(56±7)mm,t=6.454,P＜0.01;LVEF:(50±5)％ and(35±8)％,t=-6.091,P<0.01);NT-proBNp:(986±713)ng/Lvs (3328±1109) ng/L,t =17.626,P ＜ 0.05) ; CInI:(0.85±0.16) μg/L vs(2.03±0.63) μg,/L,t =5.879,P ＜ 0.01 ;6MWT:(355.6±92.5)m vs(238.8±101.4) m,t =-8.255,P ＜ 0.01].After 3 months follow-up,the condition of carvedilol combined with pravastatin group were better than carvedilol group;LVEDD:(43±5)mm vs(57±6)mm,t =5.892,P ＜0.05 ;LVESD:(42±6)mm vs(49±7) mm.t =3.243,P ＜0.01 ;LVEF:(50±5) ％ vs(42±8) ％,t =-12.036,P ＜ 0.01 ; NT-proBNP:(986±713) ng/L vs(1626±968) ng/L,t =3.603,P ＜0.01 ;cTnI:(0.85±0.16) μg/L vs(1.15±0.36) μg/L,t =3.200,P ＜ 0.01 ;6MWT:(355.6±92.5) mvs(296.2±99.5) m,t =-10.119,P ＜ 0.01].The rehospitalization rate(3.3 ％ vs 12.7％,x2 =6.224,P ＜ 0.05) and the incidence of cardiovascularevents(3.3％ vs 15.9％,x2 =5.974,P ＜ 0.05) were both decreased Significantly after treated with carvedilol combined with pravastatin.Conclusion Carvedilol combined with pravastatin can reduce the level of NT-proBNP and cTnI,improve heart function in coronary heart disease patients with chronic heart failure.
ABSTRACT
ObjectiveTo explore heart rate variability (HRV),cardiac troponin Ⅰ (cTnI),left ventricular ejection fraction (LVEF) and electrocardiogram (ECG) in order to clarify the function of cardiac autonomic nerve system and the incidence of potential myocardium injury in patients with severe brain injury.MethodsClinical data of 65 patients with severe brain injury admitted between June 2006 and June 2010 were reviewed.For the sake of comparison,patients were divided by different groupings as per different biomarkers or outcomes such as Glasgow coma scale (GCS) 6 - 8 group and GCS 3 - 5 group; cTnl ＞ 0.5 group,0.04 ＜ cTnl ＜ 0.5 group and CTnl ＜ 0.04 group; and survival group and death group.Another 30 healthy subjects were enrolled as control group.Heart rate variability (HRV) was analyzed with both timedomain and frequency domain methods based on data from 24-hour Holter monitoring.The level of serum cardiac troponin Ⅰ was detected. The left ventricular ejection fraction was measured by beside color ultrasonogram.The different relationships between HRV and GCS as well as prognosis,between cTnI and GCS as well as fatality,between cTnI and ECG,and between EF and GCS were analyzed.The computer statistical software SPSS version 13.0 was used for statistical analysis of data.ResultsAll of the 65 patents with severe brain injury were subjected to decrease in HRV.The patients of GCS 6 - 8 group and GCS 3 - 5 group showed significantly lowered HRV in comparison with control group ( P ＜ 0.05 ).The death group showed more obvious decrease in HRV than the survival group ( P ＜ 0.05 ).Fifty-one of the 65 patients had myocardial injury evidenced by increase in cardiac troponin Ⅰ.The patients of cTnl ＞0.5 group and 0.04 ＜cTnI ＜ 0.5 group showed significantly higher fatality compared with cTnI ＜ 0.04 group ( P ＜ 0.05 ).Compared with the GCS 6 ～ 8 group,more patients in the GCS 3 -5 group had abnormal serum CTnl level and lower EF.ConclusionsThere are cardiac autonomic nerve system disorders and different degrees of myocardial injury in patients with severe brain injury,and early intervention is essential to decrease the fatality of severe brain injury.
ABSTRACT
ObjectiveTo study the role of catecholamine in genesis of myocardium injury after organophosphorus poisoning (OP) in order to elucidate the underlying mechanisms of OP-induced cardiotoxicity.Methods Of 92 patients with severe acute dichlorvos poisoning,41 were consecutively enrolled for study and followed up for three months. The levels of serum creatine kinase isoenzyme myocardium (CK-MB),cardiac troponin Ⅰ (cTnI),acetylcholinesterase (AChE),acetylcholine (Ach),epinephrine and norepinephrine were assayed on the 1st,3rd and 5th days after admission and on the day of discharge.Electrocardiography was recorded every day after admission.ResultsOf them,37 (90.2％ )patients survived and four ( 9.8％ ) patients died during treatment.Sinus tachycardia was found in 37 (90.2％ ) patients and ST-T changes in 33 (80.4％ ) patients.CK-MB and cTnI levels peaked 3 days after admission,and then decreased to normal levels.Serum Ach,epinephrine and norepinephrine peaked on the 1st day after admission and then decreased.ConclusionsSevere acute dichlorvos poisoning is associated with myocardial dysfunction likely caused by increase in catecholamine levels.
ABSTRACT
Objective To investigate the relations between BNP and cTnI leveh in patients with CHF and cardiac function.Methods 75 patients with CHF were selected as observation group and another 30 healthy people were selected as control group.BNP and cTnI levels were detected by electrochemiluminescence immunoassay and the data were analyzed.Results BNP and cTnI of observation group were significantly higher than control group,the difference was statistically significant(t=3.897,4.127,all P＜0.05);comparison of BNP and cTnI levels in different classification of cardiac function of observation group had significant difference(F=4.765,5.876,allP＜0.05);Linear corrlation analysis showed that:BNP and cTnI both positively correlated to classification of cardiac function(r=0.853,0.647,all P＜0.05),BNP and cTnI increased significantly with the increase of cardiac function classification.Conclusion BNP and cTnI increased significantly in patients with CHF and closely related with cardiac function.they were ideal index to evaluate the CHF severity and had a good clinical value to judge the status and function of heart in patients with CHF.
ABSTRACT
That thranscatheter therapy of congenital heart disease (CHD) can cause myocardial injury is one of the focal points of attention in disciplines. Cardiac troponin (cTn) with its high specificity and sensitivity becomes special myocardial injury measure indicators. The types of CHD, the sizes of defect and occluder, the degree of stenosis, and the patients age and body weight, with their influence due to the concentrations of cTn,can be tested as associated risk factors of the myocardial injury.
ABSTRACT
Objective To study the independent predictors of 3-day mortality of patients with systemic in-flammatory response syndrome(SIRS) in emergency department. Method From Dec 2006 to Sep 2007, 640 pa-tients with SIRS admitted to emergency department were enrolled. Those died within one hour were excluded. Ev-ery patient was examined on plasma B-type natriuretie peptide (BNP) level and serum cardiac Troponin Ⅰ (cTNI) level. Early warning score (EWS) was calculated. Rank test was used to compare the difference of BNP,cTNI and EWS between survivors and non-survivors. Logistic regression analysis was used to determine the independent pre-dictors for death and receiver operator characteristic curve was used to determine the cutoff values. Results The mean levels of age, BNP, cTNI and EWS of patients died in 3 days were 73.5(65～80),468.5 pg/mL(161.5～1862.5 pg/mL),0.37 ng/mL(0.07～2.61 ng/mL) and 6(5～9), respectively. In survivors, the mean levels of age, BNP, cTNI and EWS were 71(60～77), 239 pg/mL(56.3～783.8 pg/mL), 0.07 ng/mL(0.03～0.26 ng/mL)and 4(3～6), respectively. There were significant difference in age, BNP, cTNI and EWS between two groups (P < 0.05). Age ≥ 76, BNP ≥ 115 pg/mL, cTNI ≥ 0.135 ng/mL and EWS ≥ 6 were independent predic-tors of death. Conclusions Levels of BNP,cTNI and EWS were predictors of death in SIRS patients during emer-gency department stay.
ABSTRACT
Objective: discussion to the dynamic change of Serum cardiac troponin Ⅰ(cTn-Ⅰ) and the diagnostic value to the myocardial damage from patients with acute cerebral hemorrhage (ACH).Methods: study a group of 98 ACH patients; Serum cTn-I is measured in 98 patients with acute cerebral hemorrhage (ACH) at 24 h, 72 h,7 d,14 d after the outbreak;Measure the nervous impairment when admission to hospital and divide it into mild, medium and heavy according to the dysfunction of nervous system;compare a group of 98 healthy physical testers and check their Serum cardiac troponin Ⅰ (cTn-Ⅰ) levels.Results: Serum cardiac troponin Ⅰ(cTn-Ⅰ) levels from 98 ACH patients at 24 h, 72 h,7 d after the outbreak are distinctly higher than that from 98 ACH patients at 14 d and 98 healthy physical testers (P0.05);the higher the nervous impairment score in NIHSS is,the higher the cardiac troponin Ⅰ (cTn-Ⅰ) level is. The three cTn-I levels are distinctly meaningful when compared at 24 h,72 h,7 d after the outbreak(P