摘要
目的观察急性心肌梗死(acute myocardial infarction,AMI)患者血清不规则趋化因子(fractalkine,FKN)、胱抑素C(Cystatin C,Cys C)浓度及心室重构的发生情况,并分析血清FKN、Cys C浓度与AMI患者发生心室重构的相关性。方法选择2020年5月至2021年5月天长市人民医院144例AMI患者作为研究对象,入院后患者均实施经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗,全部患者治疗后均接受为期6个月的随访,观察晚期心室重构发生情况并分为发生组与未发生组,比较两组患者基线资料和实验室指标(血清FKN、Cys C浓度),并分析血清FKN、Cys C浓度与晚期心室重构发生的关系。结果相较于入院1周内,完成PCI治疗后6个月两组患者的左心室舒张末期容积(left ventricular end-diastolic volume,LVEDV)增大,差异有统计学意义(P<0.001)。本研究中144例AMI患者心室重构发生率为25.69%(37/144)。Logistic回归分析结果显示,入院时血清B型脑钠肽(brain natriuretic peptide,BNP)、FKN、Cys C浓度和随访3个月时血清FKN、Cys C浓度高可能是AMI患者晚期心室重构发生的风险因子(OR>1,P<0.05)。绘制受试者工作特征曲线(receiver operating characteristic curve,ROC),结果显示,入院时血清FKN浓度、入院时血清Cys C浓度、随访3个月时血清FKN浓度、随访3个月时血清Cys C浓度预测AMI患者晚期心室重构的曲线下面积(area under the curve,AUC)分别为0.809、0.714、0.897、0.764,均有一定预测价值。绘制决策曲线,结果显示,在阈值0.0~1.0范围内,联合入院时、随访3个月时血清FKN、Cys C浓度预测AMI患者晚期心室重构的净受益率高于单独某一指标,净受益率最大值为0.257。结论AMI患者血清FKN、Cys C浓度与晚期心室重构的发生有关,入院时、随访3个月时血清FKN、Cys C浓度预测AMI患者晚期心室重构具有一定价值,联合各指标可获得较高的净受益率。
Objectives To observe the serum concentrations of fractalkine(FKN),cystatin C(Cys C)and ventricular remodeling in patients with acute myocardial infarction(AMI),and to analyze the correlation between the serum concen-trations of FKN and Cys C and ventricular remodeling in patients with AMI.Methods A total of 144 patients with AMI in Tianchang People′s Hospital from May 2020 to May 2021 were selected as the study subjects,and received percutane-ous coronary intervention(PCI)after admission.All the patients were followed up for 6 months after treatment,then their occurrence of late ventricular remodeling was observed and they were divided into occurrence group and non occur-rence group.The basic data and laboratory indexes(serum concentrations of FKN and Cys C)of the two groups were compared,and the relationship between the serum concentrations of FKN and Cys C and the late ventricular remodeling was analyzed.Results Compared with that within 1 week after admission,the average left ventricular end-diastolic vol-ume(LVEDV)increased 6 months after PCI in the two groups,and the differences were statistical significant(P<0.001).In this study,the incidence of ventricular remodeling in 144 patients with AMI was 25.69%(37/144).The re-sults of Logistic regression analysis showed that,the high serum concentrations of B-type natriuretic peptide(BNP),FKN,Cys C at admission and serum concentrations of FKN and Cys C at 3 months follow-up might be the risk factors of late ventricular remodeling in patients with AMI(OR>1,P<0.05).The receiver operating characteristic curve(ROC)was drawn,and the results showed that,the area under the curve(AUC)of FKN at admission,Cys C at admission,FKN at 3 months of follow-up and Cys C at 3 months of follow-up were 0.809,0.714,0.897 and 0.764 respectively,which had certain predictive value.The decision curve was drawn,and the results showed that,within the threshold range of 0.0-1.0,the combined serum concentrations of FKN and Cys C at admission and 3 months of follow-up in predicting the net be
作者
邬玉璐
钱改河
叶承刚
WU Yulu;QIAN Gaihe;YE Chenggang(Department of General Medicine,Tianchang People′s Hospital,Tianchang,Anhui 239399,China;Department of Neurology,Tianchang People′s Hospital,Tianchang,Anhui 239399,China;Department of Cardiology,Tianchang People′s Hospital,Tianchang,Anhui 239399,China)
出处
《岭南心血管病杂志》
CAS
2024年第1期38-44,共7页
South China Journal of Cardiovascular Diseases
关键词
心肌梗死
心室重构
不规则趋化因子
胱抑素C
myocardial infarction
ventricular remodeling
irregular chemokine
cystatin C
