摘要
目的探讨血管内超声(IVUS)参数联合microRNA-206(miR-206)评估非ST段抬高型急性心肌梗死(NSTEAMI)患者病变严重程度及预后的价值。方法选取2019年3月-2021年4月河北北方学院附属第一医院收治的105例NSTEAMI患者,所有患者行经皮冠状动脉介入术(PCI),根据病变严重程度将患者分为单支病变组(55例)、双支病变组(32例)、多支病变组(18例)。对比不同病变程度患者IVUS参数、血清miR-206,分析IVUS参数、血清miR-206与NSTEAMI患者病变严重程度的相关性。随访2年,根据是否发生MACE分为发生组与非发生组。对比发生组与非发生组的临床资料,采用多因素逐步Logistic回归模型分析NSTEAMI患者发生主要不良心脏事件(MACE)的影响因素。绘制受试者工作特征(ROC)曲线,评估IVUS参数、血清miR-206预测NSTEAMI患者发生MACE的效能。结果多支病变组斑块负荷、斑块面积、重构指数、偏心指数、血清miR-206相对表达量均高于单支、双支组(P<0.05),且双支病变组均高于单支病变组(P<0.05)。Pearson相关性分析结果显示,血管外弹力膜面积与NSTEAMI患者病变严重程度无相关性(r=0.271,P=0.325);斑块负荷、斑块面积、重构指数、偏心指数、血清miR-206与NSTEAMI患者病变严重程度呈正相关(r=0.416、0.382、0.423、0.507和0.394,均P=0.000)。随访2年,失访2例,剩余103例患者中32例(31.07%)发生MACE,71例(68.93%)未发生MACE。发生组多支病变、血运未重建占比、斑块负荷、斑块面积、重构指数、偏心指数、血清miR-206相对表达量均高于非发生组(P<0.05),淋巴细胞计数、血红蛋白水平均低于非发生组(P<0.05)。多因素逐步Logistic回归分析结果显示:多支病变[OR=3.466(95%CI:1.523,7.884)]、血运未重建[OR=2.776(95%CI:1.220,6.315)]、斑块负荷[OR=3.155(95%CI:1.387,7.177)]、重构指数[OR=3.842(95%CI:1.689,8.740)]、偏心指数[OR=4.166(95%CI:1.831,9.477)]、血清miR-206[OR=4.500(95%CI:1.978,10.236)]为NSTE
Objective To investigate the value of intravascular ultrasound(IVUS) parameters combined with microRNA-206(miR-206) in assessing the severity and prognosis of non-ST-elevation acute myocardial infarction(NSTEAMI).Methods The 105 NSTEAMI patients admitted to our hospital from March 2019 to April 2021 were selected.All patients underwent percutaneous coronary intervention(PCI) and were divided into single-vessel disease group(n = 55),double-vessel disease group(n = 32) and multi-vessel disease group(n = 18) according to the lesion severity.IVUS parameters and serum levels of miR-206 were compared among patients with different degrees of the lesion severity,and the correlations of IVUS parameters and serum levels of miR-206 levels with the lesion severity was analyzed in NSTEAMI patients.Patients were followed up for 2 years,and were further divided into the occurrence group and the non-occurrence group according to whether they had major adverse cardiac events(MACE).The clinical data of patients in the occurrence group and the non-occurrence group were compared.Multivariable Logistic regression analysis was performed to determine the factors affecting the occurrence of MACE in NSTEAMI patients.The receiver operating characteristic(ROC) curve was plotted to assess the predictive value of IVUS parameters and serum miR-206 for MACE in NSTEAMI patients.Results The plaque load,plaque area,remodeling index,eccentricity index and the serum level of miR-206 in the multi-vessel disease group were higher than those in the single-vessel disease group and the double-vessel disease group(P < 0.05),and those in the doublevessel disease group were even higher than those in the single-vessel disease group(P < 0.05).The Pearson correlation analysis revealed that there was no correlation between the external elastic membrane area and the lesion severity in NSTEAMI patients(r =0.271,P =0.325),and that the plaque load,plaque area,remodeling index,eccentricity index,and the serum level of miR-206 were positively correlated with the les
作者
张鹏祥
张爱爱
李飞星
李小宁
李卓然
李会贤
王蕊
李方江
Zhang Peng-xiang;Zhang Ai-ai;Li Fei-xing;Li Xiao-ning;Li Zhuo-ran;Li Hui-xian;Wang Rui;Li Fang-jiang(Department of Cardiovascular Medicine,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075061,China)
出处
《中国现代医学杂志》
CAS
2024年第8期45-52,共8页
China Journal of Modern Medicine
基金
2020年度河北省医学科学研究计划(No:20200510)。
