sST2 MMP-2 MMP-9与急性心肌梗死并发心力衰竭患者预后的相关性  

Correlation between sST2,MMP-2 and MMP-9 and prognosis in patients with acute myocardial infarction complicated with heart failure

作　　者：王芳[1] 韦迎娜[1] 尹涛源 WANG Fang;WEI Yingna;YIN Taoyuan(Department of Cardiovascular Medicine,the Third People’s Hospital of Hainan Province,Sanya 572000,China)

机构地区：[1]海南省第三人民医院心血管内科,三亚572000

出　　处：《安徽医学》2020年第7期755-759,共5页Anhui Medical Journal

基　　金：海南省卫生计生行业科研项目(项目编号:19A200072)。

摘　　要：目的探讨血清可溶性生长刺激表达基因2蛋白(sST2)和基质金属蛋白酶(MMP)-2、MMP-9水平与急性心肌梗死(AMI)并发心力衰竭(HF)患者预后的相关性。方法选取2017年5月至2018年5月在海南省第三人民医院住院的AMI患者149例,记录患者入院后相关数据,检测入院时血清sST2、MMP-2、MMP-9水平,根据住院期间是否并发HF分为HF组(54例)和无HF组(95例),出院后随访12个月,根据是否出现恶性HF、心源性死亡等将AMI并发HF患者分为预后不良组(n=16)和预后良好组(n=38),比较HF组和无HF组以及预后不良组和预后良好组血清sST2、MMP-2、MMP-9水平,并采用受试者工作特征(ROC)曲线分析sST2、MMP-2、MMP-9对AMI并发HF患者预后的预测价值。结果HF组血清sST2、MMP-2、MMP-9水平均高于无HF组,差异有统计学意义(P<0.05);HF组不良事件发生率为29.63%(16/54),预后不良组血清sST2、MMP-2、MMP-9水平均高于预后良好组,差异有统计学意义(P<0.05);sST2、MMP-2、MMP-9预测AMI并发HF患者预后的曲线下面积(AUC)分别为0.888、0.938、0.715。结论AMI并发HF患者血清sST2、MMP-2、MMP-9明显增高,高水平血清sST2、MMP-2、MMP-9可能提示患者预后不良,sST2、MMP-2、MMP-9对患者预后有较好的预测价值。Objective To explore the correlation between levels of serum soluble growth stimulation expressed gene 2(sST2),matrix metalloproteinase(MMP)-2 and MMP-9 and prognosis in patients with acute myocardial infarction(AMI)complicated with heart failure(HF).Methods A total of 149 patients with AMI who were hospitalized in the Third People’s Hospital of Hainan Province from May 2017 to May 2018 were s elected.The related data of patients after admission were recorded.The serum levels of sST2,MMP-2 and MMP-9 were measured at admission.According to whether HF was concurrent during hospitalization,the patients were divided into HF group(n=54)and non-HF group(n=95).At 12 months follow-up after discharge,the patients with AMI and HF were divided into poor prognosis group(n=16)and good prognosis group(n=38)according to whether there was malignant heart failure or cardiogenic death.The levels of serum sST2,MMP-2 and MMP-9 were compared between HF group and non-HF group and between poor prognosis group and good prognosis group.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of sST2,MMP-2 and MMP-9 in the prognosis of patients with AMI complicated with HF.Results The levels of serum sST2,MMP-2 and MMP-9 in HF group were higher than those in non-HF group(P<0.05).The incidence rate of adverse events was 29.63%(16/54)in HF group,and the levels of serum sST2,MMP-2 and MMP-9 in patients with poor prognosis were higher than those in patients with good prognosis(P<0.05).Multivariate logistic regression analysis found that sST2,MMP-2 and MMP-9 were independent risk factors for the prognosis of patients with AMI complicated with HF(P<0.05).The values of area under the curve(AUC)of sST2,MMP-2 and MMP-9 in predicting the prognosis of AMI patients with HF were 0.888,0.938 and 0.715 respectively.Conclusions The serum levels of sST2,MMP-2 and MMP-9 in patients with AMI and HF significantly increased,and high levels of serum sST2,MMP-2 and MMP-9 may indicate a poor prognosis,and sST2,MMP-2 and MMP-9 ha

关 键 词：可溶性生长刺激表达基因2蛋白 基质金属蛋白酶-2 基质金属蛋白酶-9 急性心肌梗死 心力衰竭 

分 类 号：R542.22[医药卫生—心血管疾病] R541.6[医药卫生—内科学]