摘要
目的评价血浆可溶性生长刺激表达因子2(s ST2)浓度对急性心肌梗死(AMI)患者出院后90天临床预后的预测价值。方法选择2017年1月至12月在新乡市中心医院住院的112例AMI患者为研究对象,依据s ST2浓度预测主要不良心血管事件(MACE)的受试者工作特征曲线(ROC)最佳临界值分为s ST2高值组和s ST2低值组。比较2组患者的临床资料及出院后90天MACE(定义为死亡、新发慢性心力衰竭)发生率。评估s ST2对MACE的预测价值。结果 2组在年龄、收缩压、糖尿病、左心室射血分数(LVEF)、心肌肌钙蛋白I(c Tn I)、N末端B型利钠肽原(NT-proBNP)浓度方面差异均有统计学意义(均P <0. 05)。s ST2与NT-proBNP (r=0. 452,P=0. 001)、c Tn I(r=0. 298,P=0. 004)呈正相关;与LVEF(r=-0. 472,P=0. 001)呈负相关。生存分析显示s ST2高值组MACE发生率高于s ST2低值组,累积生存率低于s ST2低值组(P=0. 001)。多因素Cox回归分析显示s ST2≥55. 0μg/L是AMI患者出院后90天出现MACE的危险因素(风险比为1. 154,95%CI为1. 025~1. 342,P=0. 015)。结论血浆s ST2浓度升高提示AMI患者出现死亡和心力衰竭的风险增加。
Aim To evaluate the predictive value of plasma soluble growth stimulating express gene protein 2(s ST2)concentration for clinical prognosis in 90 days after discharge of patients with acute myocardial infarction(AMI).Methods 112 patients with AMI hospitalized in Xinxiang Central Hospital from January to December 2017 were selected as subjects of study.According to the best cut-off value of receiver operating characteristic curve(ROC)for s ST2 concentration predicting major adverse cardiovascular event(MACE),the subjects were divided into high s ST2 group and low s ST2 group.The clinical data and the incidence of MACE(defined as death and new onset of chronic heart failure)for90 days after discharge were compared between two groups.The predictive value of s ST2 for MACE was evaluated.Results There were significant differences in age,systolic blood pressure,diabetes mellitus,left ventricular ejection fraction(LVEF),cardiac troponin I(c Tn I)and N-terminal pro-B type natriuretic peptide(NT-proBNP)between the two groups(all P<0.05).s ST2 was positively correlated with NT-proBNP(r=0.452,P=0.001),c Tn I(r=0.298,P=0.004)and negatively correlated with LVEF(r=-0.472,P=0.001).Survival analysis showed that the incidence of MACE in the high s ST2 group was higher than that in the low s ST2 group,and the cumulative survival rate in the high s ST2 group was lower than that in the low s ST2 group(P=0.001).Multivariate Cox regression analysis showed that s ST2≥55.0μg/L was a risk factor for MACE in patients with AMI for 90 days after discharge(hazard ratio 1.154,95%CI1.025-1.342,P=0.015).Conclusion Elevated plasma s ST2 level implies an increased risk of death and heart failure in patients with AMI.
作者
杨树涵
陈红伟
刘艳宾
邢永生
YANG Shuhan;CHEN Hongwei;LIU Yanbin;XING Yongsheng(Department of Cardiology,Xinxiang Central Hospital,Xinxiang,Henan 453000,China)
出处
《中国动脉硬化杂志》
CAS
2019年第9期783-786,801,共5页
Chinese Journal of Arteriosclerosis
关键词
可溶性生长刺激表达因子2
急性心肌梗死
N末端B型利钠肽原
主要不良心血管事件
soluble growth stimulating express gene protein 2
acute myocardial infarction
N-terminal pro-B type natriuretic peptide
major adverse cardiovascular event
