首页|血脂、cTnI和Hcy测定对危重病人诊断的临床意义

血脂、cTnI和Hcy测定对危重病人诊断的临床意义

The Clinical Significance of Determining Blood Lipid, Serum cTnI and Hcy Levels in Critically ill Patients in the Diagnosis

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目的:探讨危重病人诊断时血脂、cTnI和Hcy测定的临床意义.方法:生化法、化学发光免疫分析和电化学发光免疫分析分别测定了189例危重病人(包括63例急性心肌梗死、65例脑梗死和61例脓毒症)血脂、cTnI和Hcy水平并与60例正常对照组进行了比较性分析.结果:189例危重病人的血清TC、TG和LDL-C水平较之60例正常对照组明显降低(P分别为<0.05、<0.01,和<0.05).其中63例急性心肌梗死病人血清TC、TG和LDL-C水平P分别为<0.05、<0.01和<0.05;65例脑梗死病人P分别为<0.05、<0.01和<0.05;61例脓毒血症病人P分别为<0.05、<0.01和>0.05.189例危重病人血清Lp(a)水平较之60例正常对照组明显增高(P<0.05),其中急性心肌梗死、脑梗死和脓毒症病人P分别为>0.05、<0.01和<0.05.189例危重病人血清HDL-C水平较之60例正常对照组无明显差异(P均>0.05),其中急性心肌梗死、脑梗死和脓毒症病人亦然(P均>0.05).189例危重病人血清cTnI水平较之60例正常对照组明显增高(P<0.01),63例急性心肌梗死、65例脑梗死和61例脓毒症病人P分别为<0.001、<0.01和<0.01.189例危重病人血清Hcy水平较之60例正常对照组亦明显增高(P<0.01),63例急性心肌梗死、65例脑梗死和61例脓毒症病人P分别为<0.001、<0.001和<0.01.结论:危重病人(急性心肌梗死、脑梗死和脓毒症)血脂TC、TG和LDL-C水平明显降低或代谢紊乱,血清cTnI和Hcy水平明显增高,这是诊断危重病人时的重要标志物.
Objective To explore the clinical significance of determining blood lipid.serum oTnI and Hey levels in critically ill patients in the diagnosis. Methods The blood lipid [ (TG,TG,HDL-C,LDL-C and LP(a) ] (with biochemistty method) ,serum cTnl and Hey (with chemiluminescent immunoasaay and electrochemiuiminescence immunoassay) levels were determined in 189 cases critically ill patients( including 63 cases acute myocardial infarction,65cases cerebral infarction and 61 cases pyemia) and making of comparative analysis with controls. Results In the blood lipid analysis,the serum TC,TG and LDL-C levels in 189 cases critically ill patients were significantly lower than those in controls (P were ＜0.05,P＜0.05 and ＜0.05, respectively) .In them, P of 63 cases a-cute myocardial infarction were ＜0.05, ＜ 0.01 and ＜0.05 respectively, Pof 65 cases cerebral infarction were ＜0.05, ＜0.01 and ＜0.05 respectively, P of 61 cases pyemia were ＜0.05, ＜0.01 and ＞0.05 respectively. The serum LP(a) level in 189 cases critically ill patients was significantly higher than the controls (P＜0.05) , P of acute myocardial infarction, cerebral infarction and pyemia were ＞0.05, ＜0.01 and ＜0.05 respectively. But the serum HDL-C level was no significant difference(P all ＞0.05). In the myocardial markers analysis, the serum cTnl level in 189 cases critically ill patients showed prominently higher than that of controls (P＜0.01), P of 63 cases acute myocardial infarction,65cases cerebral infarction and 61 cases pyemia were ＜0.001, ＜0.001 and ＜0.01 individually. The serum Hey level in 189 cases critically ill patients was obviously higher than the controls (P＜0.01) also, P ＜0.001, ＜0.001 and ＜0.01 respectively. Conclusion The blood lipid (TC.TG and LDL-C etc. ) levels in critically ill patients (including acute myocaEdial infarction cerebral infarction and pyemia) were sigrnificanfly decreased or metabolic disorder but the SER um cTnI and Hey levels were notably increased, these may served as important markers for diagnosis critically ill patients.

critically ill patientsacute myocaidial infarction (AMI)cerebral infarction ( CI)pyemiablood lipidcardiac troponin I (cTnl)homocysteine (Hcy)

张志英、鲍逸民、杨永青

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南京医科大学附属苏州市立医院急诊科,215002

南京医科大学附属苏州市立医院核医学科,215002

危重病人 急性心肌梗死 脑梗死 脓毒症 血脂 肌钙蛋白I(cTnI) 同型半胱氨酸(Hcy)

2013

10.3969/j.issn.108-9810.2013.01.033

放射免疫学杂志
同济大学

放射免疫学杂志

CSTPCD
影响因子：0.508
ISSN：1008-9810
年,卷(期)：2013.26(1)
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