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目的探讨心房纤颤(房颤)合并心源性脑栓塞患者肌钙蛋白I(cTnI)水平升高的危险因素及其对病情评估的价值。方法房颤合并心源性脑栓塞患者101例,发病72h内测定cTnI水平,并分为两组:A组37例,cTnI>0.03μg/L;B组64例,cTnI≤0.03μg/L(正常水平),分析cTnI升高的相关危险因素及其与临床相关指标的关系。结果A组血糖、血清CK-MB和C反应蛋白(CRP)水平均高于B组[(7.59±5.00)mmol/L vs.(5.67±1.59)mmol/L、(24.31±23.62)U/L vs.(13.10±4.77)U/L和(33.8±49.2)mg/L vs.(10.9±24.1)mg/L](P<0.01),NIHSS评分也较B组增高[(19.8±8.2)分vs.(11.5±9.0)分](P<0.01)。治疗2周内,A组病死率高于B组[35.1%(13/37)vs.15.6%(10/64)](P<0.05)。结论肌钙蛋白升高可用于评估房颤合并心源性脑栓塞患者病情严重程度的指标之一。
Objective To investigate the risk factors of troponin I (cTnI) levels in patients with atrial fibrillation (AF) and cardioembolic embolism and to assess the value of the disease. Methods A total of 101 patients with atrial fibrillation and cardioembolism were enrolled in this study. The cTnI levels were measured within 72 hours of onset and were divided into two groups: 37 cases in group A, cTnI> 0.03μg / L; group B in 64 cases, cTnI≤0.03μg / L Normal levels), analysis of elevated cTnI related risk factors and their relationship with clinically relevant indicators. Results The levels of blood glucose, serum CK-MB and CRP in group A were significantly higher than those in group B [(7.59 ± 5.00) mmol / L vs. (5.67 ± 1.59) mmol / L, (24.31 ± 23.62) U / L NIHSS score was significantly higher than that in group B [(13.10 ± 4.77) U / L and (33.8 ± 49.2) mg / L vs. (10.9 ± 24.1) mg / L] vs. (11.5 ± 9.0) points] (P <0.01). Within 2 weeks of treatment, the mortality in group A was higher than that in group B [35.1% (13/37) vs.15.6% (10/64)] (P <0.05). Conclusion Elevated troponin can be used to evaluate the severity of AF in patients with atrial fibrillation and cardioembolism.