血清sST2、CysC联合检测对心肌梗死PCI介入治疗患者风险分级的应用价值  

Value of combined detection of serum sST2 and Cys C in risk stratification of acute myocardial infarction patients undergoing PCI

作　　者：宋辉 郑时康 施巍[3] 王丙聚 SONG Hui;ZHENG Shi-kang;SHI Wei;WANG Bing-ju(ECG Room,Ankang Central Hospital,Affiliated Hospital of Ankang Vocational and Technical College,Ankang 725000;Department of Vascular Medicine,Ankang Central Hospital,Affiliated Hospital of Ankang Vocational and Technical College,Ankang 725000;Department of Electrocardiology,Shangluo Central Hospital,Shangluo 726000,Shaanxi;Department of Internal Neurology,Xianyang Hospital of Yan an University,Xianyang 712000,Shaanxi,China)

机构地区：[1]安康市中心医院,安康职业技术学院附属医院心电图室,陕西安康725000 [2]安康市中心医院,安康职业技术学院附属医院心血管内科,陕西安康725000 [3]商洛市中心医院心电科,陕西商洛726000 [4]延安大学咸阳医院神经内科,陕西咸阳712000

出　　处：《川北医学院学报》2020年第3期413-416,共4页Journal of North Sichuan Medical College

基　　金：陕西省教育厅科学研究基金项目(16JK1867).

摘　　要：目的:研究血清可溶性基质溶素-2(sST2)联合胱抑素C(CysC)在急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)患者风险分级中的应用价值。方法:将123例行PCI治疗的AMI患者纳为研究对象,随访1年。统计患者不良心脑血管事件(MACCE)发生情况,将发生MACCE事件者纳为预后不良组,未发生MACCE事件者纳为预后良好组,比较两组临床特征及实验室指标。行COX多因素分析,统计影响AMI患者PCI治疗后不良预后的危险因素。结果:随访1年,AMI患者MACCE事件发生率为21.95%;COX单因素分析提示,预后不良组与预后良好组的年龄、Killip心功能分级、血管病变支数、最终TIMI血流分级、血清sST2及CysC水平均存在显著性差异(P<0.05);COX多因素分析提示,年龄≥60岁、最终TIMI血流分级0~2级、sST2>78.16ng/mL及CysC>1218.12 ng/mL将增大AMI患者PCI治疗后MACCE事件发生风险;AMI患者PCI治疗1年后MACCE事件累积发曲线显示:入院时血清sST2>78.16 ng/mL者MACCE累积发生率为91.16%,显著高于≤78.16ng/mL者的78.16%(P<0.05);血清CysC浓度>1218.12 ng/mL者的MACCE累积发生率为90.13%,显著高于≤1218.12 ng/mL者的70.26%;sST2≤78.16 ng/mL联合CysC≤1218.12 ng/mL MACCE累积发生率低于其余组合(P<0.05)。结论:AMI患者入院时血清sST2联合CysC水平能预测其行PCI治疗1年后MACCE事件发生风险。Objective:To investigate application value of combined detection of serum soluble stromalysin-2(sST2)and cystatin C(CysC)in risk stratification of acute myocardial infarction(AMI)patients undergoing percutaneous coronary intervention(PCI).Methods:123 AMI patients undergoing PCI were enrolled,and divided into two groups according to the presence and absence of major adverse cardiovascular and cerebrovascular events(MACCE)during the postoperative 1-year follow-up,namely,poor prognosis group and good prognosis group.The clinical characteristics and laboratory indicators of two groups were compared,and COX multivariate analysis was performed to statistically analyze the risk factors affecting the poor prognosis of AMI patients after PCI.Results:During the 1 year follow-up period,the incidence of MACCE in AMI patients was 21.95%.COX univariate analysis showed that age,Killip cardiac function classification,number of vascular lesions,final TIMI blood flow classification,serum sST2 and CysC levels had significant differences between poor prognosis group and good prognosis group(P<0.05).COX multivariate analysis suggested that age≥60,final TIMI blood flow grade of 0~2,sST2>78.16ng/mL and CysC>1218.12ng/mL would increase the risk of MACCE after PCI in AMI patients;The cumulative curve of MACCE in AMI patients after 1 year of PCI showed that the cumulative incidence of MACCE was significantly higher in patients with serum sST2>78.16ng/mL at admission than in patients with serum sST2≤78.16ng/mL(91.16%vs.78.16%,P<0.05).The cumulative incidence of MACCE in patients with serum CysC>1218.12ng/mL was significantly higher than that in patients with CysC≤1218.12ng/mL(90.13%vs.70.26%).Patients with sST2≤78.16ng/mL and CysC≤1218.12ng/mL had the lowest incidence rate of MACCE(P<0.05).Conclusion:The combined detection of serum sST2 and CysC levels of AMI patients at the admission time can predict the risk of MACCE events at 1 year after PCI.

关 键 词：血清sST2 CYSC 心肌梗死 PCI治疗 风险分级 

分 类 号：R542.22[医药卫生—心血管疾病]