急性心肌梗死患者血清HMGB2水平与梗死相关血管自发再通的相关性  

Association between serum high mobility group protein box-2 and spontaneous reperfusion of infarct-related artery in patients with acute myocardial infarction

作　　者：丁怀胜[1] 刘安康 姚建辉 王沛坚[2] Ding Huaisheng;Liu Ankang;Yao Jianhui;Wang Peijian(Department of Cardiology,Meishan City People′s Hospital,Meishan,Meishan 620010,China;Department of Cardiology,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China;Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes,Chengdu 610500,China)

机构地区：[1]四川省眉山市人民医院心血管内科,620010 [2]四川省成都医学院第一附属医院心血管内科,衰老与血管稳态四川省高等学校重点实验室,610500

出　　处：《心脑血管病防治》2020年第1期54-57,62,共5页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：国家自然科学基金项目(81400289);四川省杰出青年学术技术带头人资助计划项目(2016JQ0032)。

摘　　要：目的探讨急性心肌梗死(AMI)患者血清高迁移率族蛋白2(HMGB2)水平与梗死相关血管自发再通的相关性。方法共纳入293例拟行急诊经皮冠状动脉介入治疗(PCI)的AMI患者,PCI前检测血清HMGB2水平及相关生化指标,根据心肌梗死溶栓治疗临床试验(TIMI)血流分为两组:非自发性再通组(TIMI血流0~1级,225例)和自发性再通组(TIMI血流2~3级,68例)。应用多因素Logistic回归分析梗死相关血管自发性再通的独立预测因子。结果非自发性再通组血清HMGB2水平明显高于自发性再通组[(7.53±2.28)ng/mL:(3.24±1.26)ng/mL,P<0.01]。多因素Logistic回归分析显示,血清HMGB2水平是梗死相关血管自发性再通的独立预测因子(OR=2.18,95%CI:1.11~4.33,P<0.05)。受试者工作特征曲线显示,以2.15 ng/mL为临界值预测梗死相关血管自发性再通的预测价值敏感度为79.00%,特异度为85.00%。结论血清HMGB2低水平是AMI患者自发性再通的独立预测因子,测定血清HMGB2水平对AMI患者梗死相关血管自发性再通有较高的预测价值。Objective To assess whether serum high mobility group box-2(HMGB2)correlates with spontaneous reperfusion(SR)of the infarct-related artery in acute myocardial infarction(AMI)patients.Methods Blood samples were obtained on admission and before primary percutaneous coronary intervention(pPCI)in 293 consecutive AMI patients.Serum HMGB2 level and blood chemistry were examined.According to thrombolysis in myocardial infarction(TIMI)results,patients were divided into non-SR(TIMI 0-1,n=225)and SR(TIMI 2-3,n=68)groups.Logistic regression analysis was performed to define the independent predictors of SR.Results Serum HMGB2 was significantly higher in patients with non-SR compared to patients with SR[(7.53±2.28)ng/mL vs(3.24±1.26)ng/mL,P<0.01].A cut off HMGB2 value of 2.15 ng/ml had a predictive value of 79%to identify patients with SR(sensitivity=85%).Logistic regression analysis showed that serum HMGB2 level is an independent predictor of SR(OR=2.18,95%CI:1.11~4.33,P<0.05)for AMI patients.Conclusion A decreasing serum HMGB2 level is an independent and novel predictor of SR for AMI patients.Detection of serum HMGB2 level is helpful to predict SR in AMI patients.

关 键 词：高迁移率族蛋白2 急性心肌梗死 自发性再通 

分 类 号：R542.22[医药卫生—心血管疾病]