摘要
目的:探究超声心动图参数与血清肌红蛋白(Mb)水平联合检查对急性心肌梗死(AMI)患者预后的评估价值。方法:随机选取2018年5月—2021年5月无锡市惠山区老年病医院收治的102例AMI患者作为研究组,选取同期在本院进行体检的110例健康体检者作为对照组,所有研究对象均进行超声心动图检查和血清Mb表达水平的测定;比较两组超声心动图参数和Mb表达水平的差异。对研究组患者进行为期1年的随访,根据患者是否发生主要心血管不良事件(MACE)将其分为预后良好组和预后不良组,比较两组超声心动图参数和Mb表达水平;单因素和多因素logistic分析影响患者预后的因素;ROC曲线分析超声心动图参数和Mb水平对患者预后的评估价值。结果:与对照组相比,研究组左室射血分数(LVEF)水平降低,左室舒张末期内径(LVEDD)与Mb水平均升高,差异均有统计学意义(P<0.05)。与预后不良组相比,预后良好组LVEF水平较高,LVEDD与Mb水平均较低,差异均有统计学意义(P<0.05)。单因素分析结果显示,预后良好组与预后不良组性别、体重指数(BMI)比较,差异均无统计学意义(P>0.05);预后良好组年龄、合并高血压占比、合并糖尿病占比、Killip分级为Ⅲ、Ⅳ级占比、心率水平均低于预后不良组,差异均有统计学意义(P<0.05)。logistic回归分析结果显示,Killip分级为Ⅲ、Ⅳ级(OR=2.343),低LVEF(OR=1.857),高LVEDD(OR=2.124),高Mb(OR=2.215)水平均是影响患者预后的独立危险因素(P<0.05)。ROC曲线分析显示,LVEF的曲线下面积(AUC)为0.632,LVEDD的AUC为0.678,Mb的AUC为0.715;三者联合的AUC为0.877。结论:超声心动图参数与血清Mb水平联合检测能有效评估AMI患者临床预后情况,为改善不良预后结局提供参考。
Objective:To explore the prognostic value of combined echocardiography parameters and serum myoglobin(Mb)levels in patients with acute myocardial infarction(AMI).Method:A total of 102 AMI patients who admitted to Wuxi Huishan District Geriatric Hospital from May 2018 to May 2021 were randomly selected as the study group;meanwhile,110 healthy subjects who underwent physical examination in our hospital during the same period were selected as the control group.Echocardiography and measurement of serum Mb expression levels were performed in all study subjects,differences in echocardiographic parameters and Mb expression levels between two groups were compared.Patients in the study group were followed up for one year,and they were divided into good prognosis and poor prognosis groups according to whether they developed major adverse cardiovascular events(MACE)or not,echocardiographic parameters and Mb expression levels were compared between the two groups,univariate and multivariate logistic analysis were used to analyze factors affecting the prognosis of patient,ROC curve was used to analyze the assessment of value of echocardiographic parameters and Mb level in the prognosis of patients.Result:Compared with the control group,the left ventricular ejection fraction(LVEF)level was lower,and the left ventricular end diastolic diameter(LVEDD)and Mb levels were higher in the study group,the differences were statistically significant(P<0.05).Compared with the poor prognosis group,the good prognosis group had higher LVEF level,and lower LVEDD and Mb level,the differences were statistically significant(P<0.05).The results of univariate analysis showed that there were no significant differences in sex and body mess index(BMI)between the good prognosis group and the poor prognosis group(P>0.05);the age,comorbid hypertension,diabetes mellitus,Killip classⅢ,Ⅳpercentage,heart rate in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05).logistic regression analysis showed that Killip
作者
陈惠强
CHEN Huiqiang(Wuxi Huishan District Geriatric Hospital,Wuxi 214174,China)
出处
《中外医学研究》
2023年第7期92-96,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
急性心肌梗死
预后
超声心动图
肌红蛋白
Acute myocardial infarction
Prognosis
Echocardiography
Myoglobin
