急性ST段抬高型心肌梗死患者血清白介素18、单核细胞趋化因子1水平及其与预后的关系  

Levels of Serum IL-18 and MCP-1 in Patients with Acute ST-segment Elevation Myocardial Infarction and Their Relationship with Prognosis

作　　者：许梦阅 王洪如 XU Mengyue;WANG Hongru(Department of Cardiology,908th Hospital of PLA Joint Logistic Support Force,Nanchang 330000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院心血管内科,江西省南昌市330000

出　　处：《实用心脑肺血管病杂志》2022年第5期25-29,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨急性ST段抬高型心肌梗死(STEMI)患者血清白介素18(IL-18)、单核细胞趋化因子1(MCP-1)水平及其与预后的关系。方法选取2020年1月至2021年6月中国人民解放军联勤保障部队第九〇八医院收治的315例急性STEMI患者。采用自行设计的基线资料调查表收集患者的基线资料,包括一般资料及实验室检查指标。根据PCI后1个月患者主要不良心血管事件(MACE)发生情况,将其分为预后不良组(发生MACE)和预后良好组(未发生MACE)。采用多因素Logistic回归分析探讨急性STEMI患者预后的影响因素。采用ROC曲线、决策曲线评估血清IL-18、MCP-1水平及其联合预测急性STEMI患者不良预后的价值。结果PCI后随访1个月,315例急性STEMI患者中有87例预后不良,占27.6%。预后不良组血清IL-18、MCP-1、N末端脑钠肽前体(NT-proBNP)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)水平高于预后良好组(P<0.05)。多因素Logistic回归分析结果显示,血清IL-18、MCP-1、NT-proBNP、CK-MB水平是急性STEMI患者预后的影响因素(P<0.05)。ROC曲线分析结果显示,血清IL-18、MCP-1水平及其联合预测急性STEMI患者不良预后的AUC分别为0.812、0.770、0.840。决策曲线分析结果显示,阈值概率为0.37~0.80、0.83~0.95时,血清IL-18、MCP-1水平联合预测急性STEMI患者不良预后的净获益率优于单纯血清IL-18、MCP-1水平。结论急性STEMI患者血清IL-18、MCP-1水平升高,其与患者不良预后有关,对不良预后有一定预测价值,且二者联合预测的净获益率更高。Objective To investigate the levels of serum interleukin-18(IL-18)and monocyte chemoattractant protein-1(MCP-1)in patients with acute ST-segment elevation myocardial infarction(STEMI)and their relationship with prognosis.Methods A total of 315 patients with acute STEMI treated in 908th Hospital of PLA Joint Logistic Support Force from January 2020 to June 2021 were selected.A self-designed baseline data questionnaire was used to collect the patients'baseline data,including general data and laboratory test indicators.According to the occurrence of major adverse cardiovascular events(MACE)1 month after PCI,patients were divided into the poor prognosis group(with MACE)and the good prognosis group(without MACE).Multivariate Logistic regression analysis was used to explore the influencing factors of the prognosis of patients with acute STEMI.The value of serum IL-18 and MCP-1 levels and their combination in predicting poor prognosis in patients with acute STEMI was evaluated by ROC curve and decision curve.Results One month after PCI,87 of 315 patients with acute STEMI had poor prognosis,accounting for 27.6%.The levels of serum IL-18,MCP-1,N-terminal pro-brain natriuretic peptide(NT-proBNP),creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)of the poor prognosis group were higher than those of the good prognosis group(P<0.05).Multivariate Logistic regression analysis results showed that the levels of serum IL-18,MCP-1,NT-proBNP and CK-MB were influencing factors of prognosis in patients with acute STEMI(P<0.05).ROC curve analysis results showed that the AUC of serum IL-18,MCP-1 levels and their combination for predicting poor prognosis in patients with acute STEMI were 0.812,0.770,and 0.840,respectively.The decision curve analysis results showed that,in the threshold range of 0.37-0.80 and 0.83-0.95,the net benefit rate of combining IL-18 and MCP-1 levels in predicting poor prognosis of patients with acute STEMI was better than that of serum IL-18 or MCP-1 level alone.Conclusion The levels of serum IL-18 and MCP

关 键 词：ST段抬高型心肌梗死 经皮冠状动脉介入术 预后 白介素18 单核细胞趋化因子1 

分 类 号：R542.22[医药卫生—心血管疾病]