血清Tenascin C及CADILLAC危险评分与急诊急性心肌梗死相关性研究  

Serum Tenascin C and CADILLAC Risk Score and Emergency Acute Myocardial Infarction Correlation Study

作　　者：涂胜 王莹 刘飞 张辉[1] 刘娟[1] 韩燕如[1] 卜令同[1] TU Sheng;WANG Ying;LIU Fei;ZHANG Hui;LIU Juan;HAN Yanru;BU Lingtong(Department of Cardiology,Bozhou People's Hospital,Anhui Province,Bozhou,Anhui,China,236800)

机构地区：[1]安徽省亳州市人民医院心内科,安徽亳州236800

出　　处：《分子诊断与治疗杂志》2020年第6期715-719,共5页Journal of Molecular Diagnostics and Therapy

基　　金：国家自然科学(81670332);安徽省亳州市重点研发项目(bzzc2019018)。

摘　　要：目的探讨血清腱糖蛋白C(Tenascin C)表达水平及CADILLAC危险评分与急诊急性心肌梗死相关性研究。方法选择2018年1月至2019年3月本院心内科收治的成功行急诊经皮冠状动脉介入治疗的急性心肌梗死患者151例作为研究对象。并选择同期住院经冠状动脉造影排除冠心病诊断的患者31例作为对照组。患者在入院即刻抽取静脉血,测定血清Tenascin C及NT-proBNP,且均于本院接受冠状动脉造影及支架术治疗。根据CADILLAC危险评分预测值将ePCI-AMI患者分成三组即高危组(CADILLAC≥6)、中危组(3≤CADILLAC≤5)及低危组(CADILLAC≤2),随访1年主要不良心血管事件的发生率,包括心源性死亡、心肌梗死和靶病变血运重建等。结果 ePCI-AMI患者血清Tenascin C水平明显高于对照组(P=0.035)。高危组血清Tenascin C水平及CADILLAC危险评分显著高于中、低危组,差异均有统计学意义(P<0.05),中危组血清Tenascin C水平及CADILLAC危险评分显著高于低危组,差异有统计学意义(P<0.05)。Tenascin C水平及CADILLAC危险评分呈显著正相关(r=0.679,P<0.05),尤其是在高危组具有更高的正相关(R=0.793,P<0.05),1年的临床随访显示:高危组累计MACE较之中、低危组更高,差异具有统计学意义(P<0.05);新发心衰的发生率在数值上更高,MACE主要来源于新发心衰及心源性死亡。结论 Tenascin C水平及CADILLAC危险评分在e PCI-AMI患者的早期诊断中具有重要的临床意义,能够提示ePCI-AMI的危险程度,为不同危险程度的ePCI-AMI患者临床预后提供评估依据。Objective To investigate the serum level of Tenascin-C(TN-C)and CADILLAC risk score in patients with emergency acute myocardial infarction for early diagnosis and late prognostic. Methods151 patients with acute myocardial infarction who underwent emergency percutaneous coronary intervention in the Department of Cardiology,Bozhou People s Hospital of Anhui Province were selected as the research subjects from January 2018 to March 2019. 31 patients who were excluded coronary heart disease by coronary angiography were selected as the control group during the same time. Serum tenascin C and BNP were measured from venous blood after admission. Enrolled patients were followed up during 1-year. EPCI-AMI patients were divided into three groups according to CADILLAC risk score, and the incidence of major adverse cardiovascular events,including cardiac death,myocardial infarction and target lesions revascularization were followed up for 1 year. Results The serum TN-C level of ePCI-AMI patients was significantly higher than that of the control group(P=0.035). The serum TN-C level and CADILLAC risk score in the high-risk group were significantly higher than those of the low/middle risk groups(P<0.05),TN-C level and CADILLAC risk score showed a significant positive correlation(r=0.679),especially in the high-risk group with a higher positive correlation(R=0.793). Compared with the middle/low-risk groups,1-year clinical follow-up showed that the cumulative MACE in the high-risk group(P<0.05),the difference was statistically significant. The incidence of new-onset heart failure is numerically higher,and MACE mainly comes from new-onset heart failure and cardiogenic death. Conclusion The TN-C level and CADILLAC risk score have important clinical significance in the early diagnosis of ePCI-AMI patients,which can indicate the risk degree of ePCI-AMI and provide an evaluation basis for the clinical prognosis of ePCI-AMI patients with different risk levels.

关 键 词：急性心肌梗死 腱糖蛋白C CADILLAC危险评分 早期诊断 预后评估 

分 类 号：R542.22[医药卫生—心血管疾病]