Fractalkine与急性心肌梗死患者PCI术后无复流的关系  

The relationship between fractalkine and no-reflow after percutaneous coronary intervention in patients with acute myocardial infarction

作　　者：苏亮[1] 张春苓[1] 刘向洋 窦建新 SU Liang;ZHANG Chunling;LIU Xiangyang;DOU Jianxin(Department of CardiologyⅡ,Weifang People’s Hospital,Shandong,261041,China;Department of Endocrinology,Weifang People’s Hospital,Shandong,261041,China)

机构地区：[1]潍坊市人民医院心内二科,山东潍坊261041 [2]潍坊市人民医院内分泌科

出　　处：《临床心血管病杂志》2020年第8期701-704,共4页Journal of Clinical Cardiology

基　　金：山东省医药卫生科技发展计划项目(No:2016WSA07033)。

摘　　要：目的:研究趋化因子fractalkine与急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后无复流的关系。方法:纳入2017年10月-2019年10月潍坊市人民医院行PCI的195例AMI患者,根据心肌梗死溶栓治疗(TIMI)分级标准分为无复流组(47例)和正常血流组(148例)。比较两组患者基线资料以及相关临床指标,采用ROC曲线评价fractalkine对无复流的预测价值,Logistic逐步回归分析无复流的危险因素。结果:无复流组患者陈旧心肌梗死比例、肌钙蛋白I(cTnI)峰值、C反应蛋白(CRP)、中性粒细胞计数、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)以及fractalkine水平均显著高于正常血流组,淋巴细胞计数显著低于正常血流组(均P<0.05)。Fractalkine预测无复流的ROC曲线下面积为0.897,临界值为945.77 pg/ml,对应敏感度为78.7%,特异度为91.9%。Logistic逐步回归显示,陈旧心肌梗死、CRP、NLR以及血清fractalkine水平是无复流的独立危险因素。结论:Fractalkine是AMI患者PCI术后无复流的独立危险因素,有望成为无复流的潜在治疗靶点。Objective:To study the relationship between fractalkine and no-reflow after the percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Method:A total of 195 AMI patients who underwent PCI in Weifang People’s Hospital from October 2017 to October 2019 were included and divided into the no-reflow group(n=47)and normal flow group(n=148)according to Thrombolysis in Myocardial Infarction(TIMI)classification criteria.The baseline data and related clinical indexes were compared between the two groups.The receiver operator characteristic(ROC)curve was used to evaluate the predictive value of fractalkine for no-reflow.Logistic stepwise regression was used to analyze risk factors of no-reflow.Result:The proportion of old myocardial infarction,levels of peak cardiac troponin I(cTnI),C-reactive protein(CRP),neutrophil count,neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and fractalkine in the no-reflow group were significantly higher than those in the normal flow group,while the lymphocyte count was significantly lower than that in the normal flow group(all P<0.05).The area under the ROC curve of fractalkine for predicting no-reflow was 0.897,and the cutoff value was 945.77 pg/ml with a sensitivity of 78.7%and specificity of 91.9%.Logistic stepwise regression showed that old myocardial infarction,CRP,NLR and fractalkine were independent risk factors of no-reflow.Conclusion:Fractalkine is an independent risk factor and a potential therapeutic target of no-reflow after PCI in AMI patients.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 无复流 FRACTALKINE 

分 类 号：R542.2[医药卫生—心血管疾病]