摘要
目的研究血清纤维蛋白原/白蛋白比值(FAR)、可溶性生长刺激表达基因2蛋白(sST2)对急性冠脉综合征(ACS)经皮冠状动脉支架植入术(PCI)介入后主要不良心血管事件(major adverse cardiovascular events,MACE)发生的预测价值。方法将医院2018年1月-2020年1月华北石油管理局总医院收治的106例行PCI介入术治疗的ACS患者纳为研究对象,根据患者在院期间是否并发MACE,将其分为MACE组及NMACE组,对比两组患者一般临床资料及血液学指标(包括血清sST2、FAR),并绘制ROC曲线,分析血清sST2及FAR在预测PCI介入术后患者并发MACE的价值。结果106例ACS患者中共36例在院期间并发MACE,将其纳入MACE组。比较MACE组与NMACE组患者临床资料发现,MACE组患者年龄显著高于NMACE组(P<0.05),入院时SBP水平存在显著低于NMACE组(P<0.05),入院时N末端B型利钠肽原(NT-proBNP)水平显著高于NMACE组(P<0.05),Gensini评分及左主干病变占比显著高于NMACE组(P<0.05);两组PCI术后,血清sST2及FAR水平均较其术前显著降低(P<0.05),但MACE组患者术后血清sST2及FAR水平显著高于NMACE组(P<0.05)。多变量Logistic回归分析提示,ACS患者入院时SBP、Gensini评分、血清NT-proBNP水平及左主干病变是其PCI术后并发MACE的相关风险因素。校正相关风险因素后发现,术后血清sST2[OR=1.441,95%CI(1.157~1.794),P=0.001]及FAR[OR=1.301,95%CI(1.042~1.623),P=0.020]是PCI术后MACE发生的独立预测因素。绘制ROC曲线发现,术后血清sST2、FAR在评估ACS患者术后院内并发MACE事件中均具有良好的预测效能,其AUC分别为0.797与0.750,但两者联合应用可有效提高各指标单独应用时的效能,联合应用时AUC=0.843,95%CI(0.757~0.928)。结论PCI术后血清高水平FAR及sST2是影响ACS患者并发MACE事件的独立预测因素,且两者在预测患者术后MACE事件中具有一定的效能。
Objective To investigate the predictive values of serum soluble growth stimulation expressed gene 2(sST2)and fibrinogen-to-albumin ratio(FAR)on major adverse cardiovascular events(MACE)after percutaneous coronary in⁃tervention(PCI)in acute coronary syndrome(ACS)patients.Methods 106 ACS patients,66 males and 40 females,aged 57~77,who underwent PCI were divided into two groups according to presence or absence of MACE:MACE group and NMACE group.Peripheral venous blood samples were collected at hospitalisation.Automatic biochemical analyzer was used to test the blood fat,hematological indexes,renal and liver function indexes.Coronary arteriography and echocardiography were carried out.sST2 and FAR were tested by ELISA.The general clinical data and specific index⁃es were compared between the 2 groups.Then ROC curve was used to analyze the value of serum sST2 and FAR in pre⁃dicting MACE after PCI.Results A total of 36 patients had MACE during the hospitalization period.The age of the MACE group was significantly higher than that of the NMACE group(P<0.05).Compared with the NMACE group,the MACE group had lower systolic blood pressure(SBP)and higher N-terminal pro-B type natriuretic peptide(NT-proB⁃NP),Gensini score and proportion of left main artery disease at baseline(all P<0.05).After PCI,the serum levels of sST2 and FAR were decreased in both groups(both P<0.05),while the post-intervention levels of sST2 and FAR were still significantly higher in the MACE group than in the NMACE group(both P<0.05).Multivariate logistic regression analysis indicated that SBP,Gensini score,serum NT-proBNP level and left main coronary artery disease were the risk factors of MACE after PCI.After adjustment for related risk factors,postoperative serum sST2[OR=1.441,95%CI(1.157~1.794),P=0.001]and FAR[OR=1.301,95%CI(1.042~1.623),P=0.020]were independent predictors of MACE after PCI.ROC curve showed that postoperative serum sST2 and FAR had good predictive efficacy in the evaluation of postoperative nosocomial MACE events in ACS pati
作者
刘英华
王玉霞
卢海英
曾娟
刘亚宁
高晓丽
LIU Yinghua;WANG YuXia;LU Haiying;ZENG Juan;LIU Yaning;GAO Xiaoli(Department of Cardiology,General Hospital of North ChinaPetroleumAdministration,Renqiu,Hebei,062552,China)
出处
《中国急救复苏与灾害医学杂志》
2021年第12期1381-1385,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
健康医疗与生物医药专项(编号:182777198)
河北省科技计划项目(编号:16277738D)
河北省医学科学研究重点科题计划项目(编号:20110654)。
关键词
血清sST2
FAR
急性冠脉综合征
PCI介入术
不良心血管事件
预测价值
Soluble growth stimulation expressed gene 2(sST2)
Fibrinogen-to-albumin ratio(FAR)
Acute coronary syndrome(ACS)
percutaneouscoronaryintervention(PCI)
Majoradversecardiovascularevents(MACE)
Predictivevalue
