血清丁酰胆碱酯酶活性与急性心肌梗死患者经皮冠状动脉介入治疗术后炎症因子及短期预后的相关性  

Correlation between serum butyrylcholinesterase activity with inflammatory factors and short-term prognosis in patients with acute myocardial infarction after percutaneous coronary intervention

作　　者：顾冰[1] 王伟[1] 连蕊 李长青 Gu Bing;Wang Wei;Lian Rui;Li Changqing(Department of Cardiology, the Ninety-first Central Hospital of PLA , Jiaozuo 454000, China)

机构地区：[1]中国人民解放军第91中心医院心内科,河南焦作454000

出　　处：《临床内科杂志》2019年第6期394-398,共5页Journal of Clinical Internal Medicine

摘　　要：目的探讨血清丁酰胆碱酯酶(BuChE)活性与急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后炎症因子及短期预后的相关性。方法纳入229例接受急诊PCI术的AMI患者,检测其基线血清BuChE活性、左心室射血分数(LVEF)、白细胞介素(IL)-6、超敏C反应蛋白(hs-CRP)水平,记录住院期间主要不良心血管事件(MACE)的发生情况。采用Pearson相关分析评估血清BuChE活性与LVEF、IL-6、hs-CRP的相关性,采用受试者工作特征(ROC)曲线分析血清BuChE活性对AMI患者PCI术后发生院内MACE的预测价值。结果229例患者中,38例(16.59%)发生MACE(MACE组),191例(83.41%)患者未发生MACE(非MACE组)。MACE组患者IL-6和hs-CRP水平高于非MACE组,血清BuChE活性低于非MACE组(P<0.05)。Pearson相关分析结果显示,AMI患者入院时血清BuChE活性与PCI术后1周的LVEF呈正相关(r=0.537,P<0.001),与IL-6、hs-CRP均呈负相关(r=-0.746,P<0.001;r=-0.691,P<0.001)oROC曲线分析结果显示,入院时血清BuChE活性预测AMI患者PCI术后发生院内MACE的ROC曲线下面积(AUC)为0.693(95%CI0.552-0.834),敏感度和特异度分别为84.5%和75.0%,约登指数为0.595.结论血清BuChE活性与AMI患者的心功能和炎症反应有关,有望成为预测其PCI术后发生院内MACE的指标之一。Objective To explore the correlation between serum butyrylcholinesterase ( BuChE ) activity and inflammatory factors and short-term prognosis in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention ( PCI). Methods A total of 229 AMI patients after emergency PCI were selected. Their baseline serum BuChE activity, left ventricular ejection fraction (LVEF ), interleukin ( IL)-6, hypersensitive C-reactive protein ( hs-CRP ) were detected. Main adverse cardiac events in hospital were recorded. Correlation between serum BuChE activity and LVEF, IL-6, hs-CRP was assessed by Pearson correlation analysis. The predictive value of serum BuChE activity on short-term prognosis of AMI after PCI was analyzed by receiver operating characteristic ( ROC) curve. Results There were 38 ( 16. 59%) AMI patients with in-hospital MACE ( MACE group) and 191 (83. 41 %) patients without in-hospital MACE( non-MACE group). IL-6 and hs-CRP levels were higher than those in non-MACE group, serum BuChE activity in MACE group was lower than that in non-MACE group (P <0. 05). Results of pearson correlation analysis showed that serum BuChE activity was positively correlated with LVEF of 1 week after PCI( r = 0. 537、P <0. 001 ),and negatively correlated with IL-6 and hs-CRP(r =-0. 746,P < 0. 001;r =- 0. 691 ,P < 0. 001). Results of ROC curve analysis showed that area under ROC curve(AUC) of serum BuChE activity at admission predicting in-hospital MACE after PCI in patients with AMI was 0. 693(95% Cl 0.5520 834), and the sensitivity, specificity were 84. 5% and 75. 0% respectively. The Yoden index was 0. 595. Conclusion Serum BuChE is correlated with cardiac function and inflammatory factors in patients with AMI, which is expected to be a indicator of short-term prognosis in patients with AMI after PCI.

关 键 词：急性心肌梗死 丁酰胆碱酯酶 短期预后 炎症反应 危险因素 

分 类 号：R542.22[医药卫生—心血管疾病]