摘要
目的探讨术前肌钙蛋白I(cTnI)、N末端脑钠肽前体(NT-proBNP)及D-二聚体水平对急性冠状动脉综合征患者经皮冠状动脉介入治疗(PCI)术中无复流的预测价值。方法选取郑州颐和医院于2021年1月至2023年1月收治的急性冠状动脉综合征患者120例,均在发病12 h内给予PCI,根据术中心肌梗死溶栓治疗血流情况将其分为正常血流组(98例)及无复流组(22例),比较两组患者术前血清cTnI、NT-proBNP及D-二聚体水平,临床资料,多因素分析影响患者PCI术中无复流的影响因素,绘制受试者工作曲线(ROC)分析术前血清cTnI、NT-proBNP及D-二聚体水平对PCI术中无复流的预测价值。结果无复流组术前血清cTnI、NT-proBNP及D-二聚体水平均高于正常血流组(P<0.05);无复流组年龄高于正常血流组(P<0.05),高血压患者多于正常血流组(P<0.05);回归结果显示,血清cTnI、NT-proBNP及D-二聚体高水平均是急性冠状动脉综合征患者在PCI术中发生无复流的危险因素(P<0.05);ROC结果显示,cTnI(AUC=0.873,95%CI:0.791~0.956,P<0.001)、NT-proBNP(AUC=0.921,95%CI:0.864~0.978,P<0.001)及D-二聚体(AUC=0.827,95%CI:0.727~0.927,P<0.001)对急性冠状动脉综合征患者PCI术中发生无复流诊断价值较高。结论急性冠状动脉综合征患者术前cTnI、NT-proBNP及D-二聚体高水平是患者PCI术中发生无复流的危险因素,三者对术中发生无复流均具有一定预测价值,NT-proBNP预测价值相对较高。
Objective To discuss the predictive value of levels of preoperative cardiac troponin I(cTnI),N-terminal pro-brain natriuretic peptide(NT-proBNP)and D-dimer(D-D)to no-reflow in patients with acute coronary syndrome(ACS)during percutaneous coronary intervention(PCI).Methods ACS patients(n=120)were chosen from Zhengzhou Yihe Hospital from Jan.2021 to Jan.2023,and all of them were given PCI within 12 h after ACS onset.The patients were divided into normal flow group(n=98)and no reflow group(n=22)according to blood flow after thrombolysis in myocardial infarction during PCI.The levels of preoperative serum cTnI,NT-proBNP and D-D and clinical materials were compared between 2 groups.The influence factors for no-reflow were analyzed by using multi-factor regression analysis,and predictive value of levels of preoperative serum cTnI,NT-proBNP and D-D to no-reflow was analyzed by using ROC curve.Results The levels of preoperative serum cTnI,NT-proBNP and D-D were higher(P<0.05),age was older(P<0.05),and hypertensive patients were more(P<0.05)in no reflow group than those in normal flow group.The results of regression analysis showed that higher levels of preoperative cTnI,NT-proBNP and D-D were risk factors for no-reflow in ACS patients during PCI.The results of ROC curve analysis showed that cTnI(AUC=0.873,95%CI:0.791-0.956,P<0.001),NT-proBNP(AUC=0.921,95%CI:0.864-0.978,P<0.001)and(AUC=0.827,95%CI:0.727-0.927,P<0.001)had higher diagnostic value to no-reflow in ACS patients during PCI.Conclusion The high levels of preoperative cTnI,NT-proBNP and D-D are risk factors for no-reflow in ACS patients during PCI,and they have some predictive value to no-reflow occurrence,and predictive value of NT-proBNP is higher.
作者
李世良
张津睿
赵映璇
刘彩霞
Li Shiliang;Zhang Jinrui;Zhao Yingxuan;Liu Caixia(Intensive Care Unit,Department of Cardiovascular Medicine,Zhengzhou Yihe Hospital,Zhengzhou 450000,China;不详)
出处
《中国循证心血管医学杂志》
2024年第11期1323-1326,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
河南省医学科技攻关计划联合共建项目(LHGJ20210615)。
