神经药理学报

神经药理学报 ›› 2026, Vol. 16 ›› Issue (1): 23-.DOI: 10.3969/j.issn.2095-1396.2026.01.004

• 研究论文 • 上一篇    下一篇

和肽素联合TIMI 评分对急性ST 段抬高型心肌梗死合并心力衰竭患者预后的评估价值

王子帅，东野鸿方，刘加齐，李方江   

  1. 1. 河北北方学院 研究生学院，张家口，075000，中国 

    2. 河北北方学院附属第一医院心血管内科，张家口，075000，中国

  • 出版日期:2026-03-02 发布日期:2026-05-07
  • 作者简介:王子帅，河北北方学院2023 级硕士研究生；研究方向：心血管内科

The Evaluation Value of Peptide Combined with TIMI Score for the Prognosis of Patients with Acute ST-Segment Elevation Myocardial Infarction Complicated with Heart Failure

WANG Zi-shuai, DONGYE Hong-fang, LIU Jia-qi, LI Fang-jiang   

  1. 1. Graduate School, Hebei North University, Zhangjiakou, 075000, China 

    2. Department of Cardiology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China

  • Online:2026-03-02 Published:2026-05-07

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摘要：

目的：探讨血清和肽素（copeptin）水平联合心肌梗死溶栓治疗危险评分（TIMI）对急性ST 段抬高型心 肌梗死（ST-segment elevation myocardial infarction, STEMI）合并心力衰竭（heart failure, HF）患者预后的评估 价值。方法：选取107 例确诊急性心肌梗死后HF 患者进行TIMI 评分，根据评分结果分为低危组（0~3 分）31 例， 中危组（4~6 分）42 例，高危组（7~14 分）34 例。根据copeptin 水平分为低copeptin 组60 例及高copeptin 组47 例。比较TIMI 低、中、高危组患者及低、高copeptin 组患者出院后180 d 内再发/ 未发生主要心脏不良事件(major adverse cardiovascular events, MACE) 患者的血清copeptin 水平及TIMI 评分。结果：低、中、高危组患者血清 copeptin 水平分别为(17.59±3.06)、(22.76±5.01)、(43.04±11.55) pmol·L-1，copeptin 水平随着TIMI 评分上升 而升高，差异有统计学意义（P<0.05）。出院后随访180 d，再发MACE 者29 例，未发生MACE 者78 例；再发 MACE 者血清copeptin 水平明显高于未发生MACE 者的[(40.70±12.22) vs (20.13±4.92) pmol·L-1, P<0.05]； 再发MACE 者的TIMI 评分明显高于未发生MACE 者[(8±4) vs (5±3) 分, P<0.05]。180 d 临床随访期间，高 copeptin 组心源性死亡累积发生率高于低copeptin 组 (P<0.05）。结论：血清copeptin 联合TIMI 评分对STEMI 合并HF 患者预后评估具有积极临床参考价值。

关键词: 和肽素, 心肌梗死溶栓治疗危险评分, ST 段抬高型心肌梗死, 心力衰竭, 生物标志物

Abstract:

Objective: To investigate the prognostic value of serum copeptin level combined with thrombolysis in myocardial infarction (TIMI) score in patients with acute STsegment elevation myocardial infarction (STEMI) complicated with heart failure (HF). Methods: A total of 107 patients with HF after acute myocardial infarction were selected for TIMI score. According to the score results, they were divided into low-risk group (0~3 points) with 31 cases, medium-risk group (4~6 points) with 42 cases, and high-risk group (7~14 points) with 34 cases. According to the level of copeptin, they were divided into low copeptin group (60 cases) and high copeptin group (47 cases). The serum copeptin levels and TIMI scores of patients with low, medium and high-risk groups of TIMI and patients with low and high copeptin groups with recurrence/no MACE within 180 days after discharge were compared. Results: The levels of serum copeptin in the low, medium and high-risk groups were (17.59±3.06), (22.76±5.01) and (43.04±11.55) pmol·L-1, respectively. The level of copeptin increased with the increase of TIMI score, and the difference was statistically significant (P<0.05). After 180 days of follow-up, there were 29 cases of major adverse cardiac events (MACE) and 78 cases without MACE. The serum copeptin level in patients with recurrent MACE was significantly higher than that in patients without MACE [ (40.70±12.22) vs (20.13±4.92) pmol·L-1, P<0.05]. The TIMI score of patients with recurrent MACE was significantly higher than that of patients without MACE [ (8±4) vs (5 ±3), P<0.05]. During the 180-day clinical follow-up, the cumulative incidence of cardiac death in the high copeptin group was higher than that in the low copeptin group (P<0.05). Conclusion: Serum copeptin combined with TIMI score has positive clinical reference value for prognosis evaluation of STEMI patients with HF.

Key words: copeptin, TIMI risk score for myocardial infarction thrombolytic therapy, STEMI, heart failure, biomarker

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