急性心肌梗死患者血清人软骨糖蛋白39、可溶性肿瘤坏死因子受体1水平与心功能及预后的相关性  

Correlation between serum levels of human cartilage glycoprotein 39, soluble tumor necrosis factor receptor 1 and cardiac function, prognosis in patients with acute myocardial infarction

作　　者：张占帅[1] 秦少强[1] 王亚玲[1] 石金铮[1] 王蕊[1] ZHANG Zhanshuai;QIN Shaoqiang;WANG Yaling;SHI Jinzheng;WANG Rui(Department of Cardiology,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院心内科,河北省张家口市075000

出　　处：《中国动脉硬化杂志》2022年第3期243-247,259,共6页Chinese Journal of Arteriosclerosis

基　　金：张家口市2016年度科技计划自筹经费项目(1621079D)。

摘　　要：目的分析急性心肌梗死(AMI)患者血清人软骨糖蛋白39(YKL-40)、可溶性肿瘤坏死因子受体1(sTNFR1)水平与心功能及预后之间的关系。方法选取2016年3月—2018年10月在河北北方学院附属第一医院就诊的77例AMI患者为研究对象(AMI组),选取同期在该院健康体检的77例为对照组。对AMI患者出院后随访,记录患者预后情况,随访时间为24个月。超声心动图测定两组心功能参数左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室后壁厚度(LVPWT);酶联免疫吸附法测定血清YKL-40、sTNFR1水平;Pearson法分析血清YKL-40、sTNFR1水平与AMI患者心功能参数的相关性;分析血清YKL-40、sTNFR1水平与AMI患者预后不良的关系;COX回归分析影响AMI患者预后不良的危险因素。结果与对照组比较,AMI组血清YKL-40、sTNFR1水平和LVEDD、LVPWT显著升高,LVEF显著降低(P<0.05)。随着AMI患者心功能分级的升高,血清YKL-40、sTNFR1水平逐渐升高(P<0.05)。AMI患者血清YKL-40、sTNFR1水平与LVEF呈负相关,与LVEDD、LVPWT呈正相关(P<0.05)。AMI患者YKL-40高水平组、sTNFR1高水平组的预后不良发生率均高于低水平组(P<0.05)。多因素COX分析表明,心肌梗死类型、梗死部位与血清YKL-40、sTNFR1水平是影响AMI患者预后不良的危险因素(P<0.05)。结论AMI患者血清YKL-40、sTNFR1水平与心功能和预后不良的发生相关,可能是评估AMI患者预后的潜在生物标志物。Aim To analyze the relationship between the levels of serum human cartilage glycoprotein 39(YKL-40),soluble tumor necrosis factor receptor 1(sTNFR1)and cardiac function and prognosis in patients with acute myocardial infarction(AMI).Methods 77 patients with AMI treated in the First Affiliated Hospital of Hebei North University from March 2016 to October 2018 were selected as the research object(AMI group),and 77 cases undergoing health physical examination in the hospital in the same period were selected as the control group.AMI patients were followed up after discharge,and the prognosis was recorded;The follow-up time was 24 months.Left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)and left ventricular posterior wall thickness(LVPWT)were measured by echocardiography;Serum YKL-40 and sTNFR1 levels were determined by enzyme-linked immunosorbent assay;Pearson method was used to analyze the correlation between serum YKL-40,sTNFR1 levels and cardiac function parameters in AMI patients;The relationship between serum YKL-40,sTNFR1 levels and poor prognosis was analyzed in AMI patients;The risk factors affecting the poor prognosis of AMI patients were analyzed by COX regression.Results Compared with the control group,the levels of serum YKL-40,sTNFR1,LVEDD and LVPWT were significantly increased,and LVEF was significantly decreased in AMI group(P<0.05).With the increase of cardiac function grade in AMI patients,the levels of serum YKL-40 and sTNFR1 increased gradually(P<0.05).The levels of serum YKL-40 and sTNFR1 were negatively correlated with LVEF and positively correlated with LVEDD and LVPWT in AMI patients(P<0.05).In AMI patients,the incidences of poor prognosis in high-level YKL-40 group and high-level sTNFR1 group were higher than those in low-level group(P<0.05).Multivariate COX analysis showed that the type and location of myocardial infarction and the levels of serum YKL-40 and sTNFR1 were risk factors for poor prognosis in AMI patients(P<0.05).Conclusion The levels of serum

关 键 词：急性心肌梗死 人软骨糖蛋白39 可溶性肿瘤坏死因子受体1 心功能 预后 

分 类 号：R54[医药卫生—心血管疾病]