可溶性生长刺激表达因子2与急性心肌梗死后左心室重塑的相关性分析  

Correlation between Soluble Growth Stimulating Factor 2 and Left Ventricular Remodeling after Acute Myocardial Infarction

作　　者：阮文婷[1] 魏希进[1] 管琳[1] RUAN Wen-ting;WEI Xi-jin;GUAN Lin(Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong Jinan 250014)

机构地区：[1]山东中医药大学附属医院,山东济南250014

出　　处：《医学临床研究》2022年第1期41-43,47,共4页Journal of Clinical Research

摘　　要：【目的】探讨可溶性生长刺激表达因子2(sST2)与急性心肌梗死(AMI)后左心室重塑的相关性。【方法】选择2019年3月至2020年3月本院收治的126例AMI患者,根据出院后第6个月超声心动图结果判断是否存在左心室重塑,将其分为观察组(存在左心室重塑,n=31)及对照组(不存在左心室重塑,n=95)。比较两组患者血脂、心肌损伤标志物及血清sST2水平,采用受试者工作特征(ROC)曲线评价sST2诊断AMI患者6个月后左心室重塑的临床价值。【结果】两组患者血脂及肌酸激酶同工酶(CK-MB)水平比较,差异无统计学意义(P>0.05);观察组氨基末端B型脑钠肽前体(NT-proBNP)、肌钙蛋白I(cTnI)、sST2水平显著高于对照组,差异有统计学意义(P<0.05)。出院6个月,观察组左心室舒张末期容积(LVEDV)水平高于入院1周,LVEDV、△LVEDV水平高于对照组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,sST2与cTnI、LVEDV及△LVEDV均呈正相关(r=0.419、0.517、0.642,均P<0.05),与左心室射血分数(LVEF)呈负相关(r=-0.365,P<0.05)。ROC曲线分析显示,sST2诊断AMI患者左心室重塑的价值曲线下面积(AUC)(95%CI)为0.79(0.71~0.87),最佳诊断界值为9.86ng/mL。【结论】AMI后左心室重塑患者sST2水平显著增加,sST2是评估左心室重塑的潜在指标。【Objective】To investigate the correlation between soluble growth stimulating expression gene 2(sST2)and left ventricular remodeling after acute myocardial infarction(AMI).【Methods】A total of 126 patients with AMI treated in our hospital from March 2019 to March 2020 was selected.According to the echocardiographic results of the sixth month after discharge,they were divided into observation group(left ventricular remodeling,n=31)and control group(no left ventricular remodeling,n=95).Blood lipid,myocardial injury markers and serum ST2 levels were compared between the two groups.The clinical value of sST2 in the diagnosis of left ventricular remodeling in patients with AMI after 6 months was evaluated by receiver operating characteristic(ROC)curve.【Results】There was no significant difference in the levels of blood lipid and creatine kinase isoenzyme(CK-MB)between the two groups(P>0.05);The levels of N-terminal pro brain natriuretic peptide(NT-proBNP),troponin I(cTnI)and sST2 in the observation group were significantly higher than those in the control group(P<0.05).Six months after discharge,the level of left ventricular end diastolic volume(LVEDV)in the observation group was higher than that in the control group for one week,and the levels of LVEDV and△LVEDV in the observation group were higher than those in the control group(P<0.05).Pearson correlation analysis showed that sST2 was positively correlated with cTnI,LVEDV and△LVEDV(r=0.419,0.517,0.642,mean P<0.05),and negatively correlated with left ventricular ejection fraction(LVEF)(r=-0.365,P<0.05).ROC curve analysis showed that the area under the value curve(AUC)(95%CI)of sST2 in the diagnosis of left ventricular remodeling in patients with AMI was 0.79(0.71~0.87),and the best diagnostic limit was 9.86 ng/mL.【Conclusion】The level of sST2 in patients with left ventricular remodeling after AMI is significantly increased.sST2 is a potential index to evaluate left ventricular remodeling.

关 键 词：心肌梗死 急性病 心室功能 左 

分 类 号：R542.22[医药卫生—心血管疾病]