急性心肌梗死PCI术后肺部感染患者外周血Ang-2及肌红蛋白和降钙素原与心肌酶谱的相关性  

Correlation between peripheral blood Ang-2, myoglobin, procalcitonin and myocardial enzyme spectrum in patients with lung infection after PCI in acute myocardial infarction

作　　者：刘金艳 段云鹏 刘建伟[3] 李德立 王静雅 LIU Jin-yan;DUAN Yun-peng;LIU Jian-wei;LI De-li;WANG Jing-ya(Chengde Central Hospital,Chengde,Hebei 067000,China)

机构地区：[1]承德市中心医院护理部,河北承德067000 [2]承德市中心医院急诊科,河北承德067000 [3]承德市中心医院心胸外科,河北承德067000 [4]承德市中心医院内分泌科,河北承德067000 [5]承德市中心医院重症医学科,河北承德067000

出　　处：《中华医院感染学杂志》2020年第19期2965-2969,共5页Chinese Journal of Nosocomiology

摘　　要：目的探讨外周血促血管生成素2(Angiogenin-2,Ang-2)、肌红蛋白(Myoglobin,Mb)、降钙素原(Procalcitonin,PCT)在急性心肌梗死(Acute myocardial infarction,AMI)经皮冠状动脉介入治疗(Percutaneous coronary intervention,PCI)术后肺部感染中的表达及与心肌酶谱的相关性。方法选取医院2016年7月-2019年7月AMI患者147例为研究对象,均行PCI术,根据术后是否发生肺部感染分为感染组25例和未感染组122例。比较两组入院时、确诊感染时、出院时外周血Ang-2、Mb、PCT及心肌酶谱[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌酸脱氢酶(LDH)]水平,分析外周血Ang-2、Mb、PCT诊断价值及与心肌酶谱关系。结果确诊感染时、出院时感染组外周血Ang-2、Mb、PCT分别为(152.04±31.17)U/L、(106.79±22.38)μg/L、(0.45±0.12)ng/ml和(76.14±18.39)U/L、(71.14±16.07)μg/L、(0.21±0.07)ng/ml高于未感染组(P<0.001);外周血Ang-2、Mb、PCT联合诊断PCI术后肺部感染的AUC值为PCT>Ang-2>Mb,联合检测敏感度为80.00%,特异度为90.98%;感染组确诊感染时和出院时CK、CK-MB、LDH分别为(273.30±42.25)U/L、(8.22±2.21)ng/ml、(422.50±51.18)U/L和(182.36±28.41)U/L、(4.37±1.16)ng/ml、(246.32±32.07)U/L高于未感染组(P<0.001);确诊感染时、出院时外周血Ang-2、Mb、PCT水平与CK、CK-MB、LDH水平呈正相关(P<0.001)。结论AMI患者PCI术后外周血Ang-2、Mb、PCT水平均不同程度升高,继发肺部感染患者升高更显著,且与心肌酶谱水平关系密切,PCI术后检测Ang-2、Mb、PCT水平对肺部感染发生具有监测作用。OBJECTIVE To investigate the expression of peripheral blood angiopoietin 2(Ang-2), myoglobin(Mb), and procalcitonin(PCT) in pulmonary infection after percutaneous coronary intervention(PCI) for acute myocardial infarction(AMI) and its correlation with myocardial enzyme spectrum. METHODS A total of 147 patients with AMI from Jul. 2016 to Jul. 2019 in the hospital were selected as the research subjects, all of whom underwent PCI. According to whether postoperative pulmonary infection occurred, they were divided into 25 cases in the infected group and 122 cases in the uninfected group. The levels of peripheral blood Ang-2, Mb, PCT and myocardial enzyme spectrum [creatine kinase(CK), creatine kinase isoenzyme(CK-MB), and creatine dehydrogenase(LDH)] at admission, diagnosis of infection and discharge were compared, and the diagnostic value of peripheral blood Ang-2, Mb, PCT and the relationship with myocardial enzyme spectrum were analyzed. RESULTS The levels of Ang-2, Mb, and PCT in the peripheral blood of the infected group at the time of diagnosis of infection and discharge from hospital were(152.04±31.17) U/L,(106.79±22.38) μg/L,(0.45±0.12) ng/mL and(76.14±18.39)) U/L,(71.14±16.07) μg/L,(0.21±0.07) ng/ml, respectively, significently higher than those in the uninfected group(P<0.001). Combined diagnosis AUC value of peripheral blood Ang-2, Mb, PCT of pulmonary infection after PCI were >PCT>Ang-2>Mb, the sensitivity of the joint detection was 80.00%, specificity was 90.98%. The CK, CK-MB and LDH of the infected group at the time of diagnosis of infection and discharge from hospital were(273.30±42.25) U/L,(8.22±2.21) ng/ml,(422.50±51.18) U/L and(182.36±28.41) U/L,(4.37±1.16) ng/ml,(246.32±32.07) U/L, respectively, significently higher than those of the uninfected group(P<0.001). The level of peripheral blood Ang-2, Mb, and PCT were positively correlated with CK, CK-MB, and LDH levels at the time of infection diagnosis and discharge(P<0.001). CONCLUSION The levels of Ang-2, Mb and PCT in peripheral blood

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 促血管生成素2 肌红蛋白 降钙素原 心肌酶谱 

分 类 号：R542.22[医药卫生—心血管疾病]