冠状动脉支架置入术患者外周血髓过氧化物酶水平与心脏不良事件的相关性  

Correlation between myeloperoxidase levels and adverse cardiac events in patients undergoing coronary stent implantation

作　　者：耿国英[1] 赵玉洁[1] 巴宁[1] 毛磊[1] 吴雷[1] 陈文山[1] 刘恒亮[1] Geng Guoying;Zhao Yujie;Ba Ning;Mao Lei;Wu Lei;Chen Wenshan;Liu Hengliang(Department of Cardiology,Zhengzhou People's Hospital,Zhengzhou 45000,China)

机构地区：[1]郑州人民医院心血管内科,郑州45000

出　　处：《中华老年医学杂志》2019年第5期533-536,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨冠状动脉(冠脉)支架置入术患者外周血髓过氧化物酶(MPO)水平与心脏不良事件的相关性研究。方法本研究选取2015年1月至2016年6月我院心脏内科收治的76例行冠脉支架置入术患者,采用酶联免疫吸附法(ELISA)测定血清MPO、超敏C反应蛋白(hs-CRP)、白介素6(IL-6)水平,随访1年后,采用受试者工作特征曲线(ROC)测定手术前后MPO差值(ΔMPO)对冠脉支架置入术远期预后的预测价值,运用Logistic多因素回归分析ΔMPO与冠心病传统危险因素及心脏不良事件间的相关性。结果冠脉支架置入术后患者血清MPO、hs-CRP、IL-6水平较术前均明显升高(P<0.05)。ROC曲线分析结果显示血清ΔMPO的曲线下面积(AUC)值为0.786,95%可信区间为0.471~1.000,ΔMPO用于心脏不良事件的预测具有显著性意义(P<0.05)。ΔMPO仅与年龄存在明显相关性,且心脏不良事件的发生率随着ΔMPO水平的升高而升高。Logistic回归分析显示,血清ΔMPO水平可以初步诊断冠脉支架置入术后的心血管风险,对心脏不良事件的发生有独立的预测作用。结论冠脉支架置入术后患者外周血中MPO水平较术前明显升高,血清ΔMPO水平可以初步诊断冠脉支架置入术后的心脏不良事件,可以作为预测心脏不良事件的标志物。Objective To investigate the correlation between myeloperoxidase(MPO)levels and adverse cardiac events in patients undergoing coronary stent implantation. Methods A total of 76 patients undergoing coronary stent implantation from January 2015 to June 2016 in the cardiac surgery department of our hospital were enrolled in this study.Serum levels of MPO, high sensitivity C-reactive protein(hs-CRP), and interleukin 6(IL-6)were detected by enzyme-linked immunosorbent assays(ELISA). After a one-year follow-up, the receiver operating characteristic(ROC)curve was used to determine the predictive value of the difference in MPO before and after the operation(ΔMPO)on the long-term prognosis of patients after coronary stent implantation.The correlations of ΔMPO with the traditional risk factors for coronary heart disease and adverse cardiac events were analyzed using multi-factor Logistic regression analysis. Results Serum levels of MPO, hs-CRP and IL-6 increased in patients after coronary stent implantation, compared with those before treatment(P<0.05). The results of ROC curve analysis showed that the area under the curve(AUC)value of serum ΔMPO was 0.786, the 95% confidence interval was 0.471~1.000 and the predictive value of serum ΔMPO for adverse cardiac events was significant(P<0.05). There was a significant correlation between ΔMPO and age, and the incidence of adverse cardiac events increased with increased ΔMPO levels.Logistic regression analysis showed that serum ΔMPO levels could preliminarily diagnose the cardiovascular risk after coronary stent implantation and independently predict the occurrence of adverse cardiac events. Conclusions MPO levels in peripheral blood are notably elevated in patients after coronary stent implantation when compared with pre-treatment levels.Serum ΔMPO levels can preliminarily diagnose adverse cardiac events after coronary stent implantation and can be used as a marker to predict adverse cardiac events.

关 键 词：冠心病 支架 过氧化物酶 

分 类 号：R654.2[医药卫生—外科学]