血清鸢尾素与非ST段抬高型心肌梗死患者冠状动脉病变严重程度及预后关系研究  

Correlation between serum irisin level and coronary artery lesion severity and prognosis in patients with non-ST-segment elevation myocardial infarction

作　　者：耿丽[1] 李兴华[1] 安辉[1] 程连房[1] GENG Li;LI Xinghua;AN Hui;CHENG Lianfang(Department of Critical Care Medi cine,The First Central Hospital of Baoding,Baoding Hebei 071000,China)

机构地区：[1]保定市第一中心医院重症医学科,河北保定071000

出　　处：《中国急救复苏与灾害医学杂志》2020年第9期1030-1033,1041,共5页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的 分析血清鸢尾素(Irisin)在非ST段抬高型心肌梗死(NSTEMI)冠脉病变严重程度及预后评估中的价值.方法 纳入行经皮冠脉介入(PCI)治疗的NSTEMI患者402例,检测血清Irisin水平,随访并记录主要不良心脑血管事件(MACCE)发生情况.采用Pearson相关分析血清Irisin水平与患者SYNTAX评分的相关性;采用COX比例风险回归模型分析NSTEMI患者MACCE的影响因素;采用Kaplan-Meier曲线比较不同Iri-sin水平NSTEMI患者总MACCE发生率的差异;采用受试者工作特征(ROC)曲线探索血清Irisin对MACCE的预测效能.结果 共378例NSTEMI患者完成随访,平均随访(28±14)个月;血清Irisin水平与NSTEMI患者SYNTAX评分呈负相关(r=-0.525,P<0.001);年龄(HR=1.169,95%CI:1.013~1.349)、高血压病(HR=1.185,95%CI:1.021~1.376)、2型糖尿病(HR=1.196,95%CI:1.035~1.383)、血清Irisin(HR=1.330,95%CI:1.018~1.738)是NSTEMI患者发生MACCE的独立影响因素(P<0.05);Kaplan-Meier生存曲线示,高Irisin患者总MACCE发生率显著低于低Irisin患者(Log Rank=10.052,P<0.001);血清Irisin水平预测MACCE的ROC曲线下面积为0.795(95%CI:0.691~0.864),最佳截断值为13.63 mg/L,灵敏度为85.09%,特异度为77.31%.结论 NSTEMI患者血清Irisin水平与冠脉病变严重程度呈负相关,且是此类患者MACCE的独立影响因素,可辅助临床优化对NSTEMI的危险分层管理.Objective To investigate the correlation between serum irisin level and coronary artery lesion severity and prognosis in patients with non-ST-segment elevation myocardial infarction(NSTEMI).Methods 402 patients with NSTEMI who underwent percutaneous coronary intervention(PCI)were enrolled and their major adverse cere-bral cardiovascular events(MACCE)were recorded.Pearson correlation analysis was used to analyze the correla-tion between serum irisin level and Syntax scores in patients with NSTEMI.C0X proportional hazard regression model was used to analyze the independent predictors of MACCE in patients with NSTEMI.Kaplan-Meier curves were used to compare the MACCE rates between low-lrisin patients and high-lrisin patients.ROC curve was employed to investigate the efficacy of serum lrisin in MACCE prediction.Results A total of 378 patients with NSTEMI completed fllow-up.The average fllow-u time was(28±14)month.Serum irisin level was negatively correlated with Syntax score(r=-0.525,P<0.001).Multivariate C0X regression analysis demonstrated that age(HR=1.169,95%CI:1.013~1.349),type 2 diabetes(HR=1.196,95%CI:1.035-1.383),bypertension(HR=1.185,95%CI:1.021~1.376),irisin level(HR=1.330,95%CI:1.018~1.738)were independent predictors of MACCE in patients with NSTEMI.Kaplan-Meier curves showed that the non-MACCE rate of high-irisin patients was signifi-cantly higher than that of low-irisin patients(Log Rank=10.052,P<0.001).ROC curve exhibited that the area un-der the curve was 0.795(95%Cl:0.691~0.864)for irisin predicting MACCE with an cut-off value of 13.63 mg/L,a sensitivity of 85.09%,a speeifcity of 77.31%.Conclusion The level of serum irisin is negatively correlated with the coronary artery lesion severity and can be used for predicting the poor prognosis in patients underwent PCI with NSTEMI.

关 键 词：鸢尾素 非ST段抬高型心肌梗死 经皮冠脉介入治疗 预后 

分 类 号：R541.4[医药卫生—心血管疾病]