心肌肌钙蛋白Ⅰ、高敏-C反应蛋白、N末端脑钠肽前体对急性ST段抬高型心肌梗死患者经皮冠脉介入术后主要心血管不良事件的预测价值  

Predictive value of cardiac troponin Ⅰ, high sensitivity-C-reactive protein,and N-terminal brain natriuretic peptide precursors for major adverse cardiovascular events in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention

作　　者：陶红志 余国忠 TAO Hongzhi;YU Guozhong(Department of Cardiovascular Medicine,Tongling Municipal Hospital,Anhui Province,Tongling 244000,China)

机构地区：[1]安徽省铜陵市立医院心血管内科,安徽铜陵244000

出　　处：《中国医药导报》2022年第23期57-61,共5页China Medical Herald

基　　金：安徽省高等学校省级质量工程项目(KJ2018A0273)。

摘　　要：目的 分析心肌肌钙蛋白Ⅰ(c TnI)、高敏-C反应蛋白(hs-CRP)、N末端脑钠肽前体(NT-proBNP)对急性ST段抬高型心肌梗死(STEMI)患者经皮冠动脉介入术(PCI)后主要心血管不良事件(MACE)的预测价值。方法 选择2017年10月至2021年5月安徽省铜陵市立医院收治77例接受PCI治疗且成功的STEMI患者,根据术后6个月内是否发生MACE分为发生组(15例)与未发生组(62例)。PCI术前检测所有患者血清cTnI、hs-CRP、NT-proBNP水平,logistic多因素回归法分析危险因素,受试者操作特征(ROC)分析预测价值。结果 发生组年龄、病变血管≥2个例数占比、术前B型利钠肽、血清cTnI、hs-CRP、NT-proBNP水平高于未发生组(P <0.05)。logistic多因素分析结果显示,年龄(OR=3.271,95%CI:1.346~7.949,P <0.05)、病变血管≥2个(OR=3.463,95%CI:0.425~8.415,P <0.05)、术前血清cTnI水平(OR=2.766,95%CI:1.142~6.747,P <0.05)、术前血清hs-CRP水平(OR=2.757,95%CI:1.134~6.699,P <0.05)、术前血清NT-proBNP水平(OR=3.846,95%CI:1.582~9.347,P <0.05)均为STEMI患者PCI术后6个月内发生MACE的影响因素。ROC曲线结果显示,术前血清cTnI、hs-CRP、NTproBNP水平预测STEMI患者PCI术后6个月内发生MACE的AUC值分别为0.811、0.681、0.718(P <0.05)。结论 血清cTnI、hs-CRP、NT-proBNP水平在预测STEMI患者PCI术后发生MACE中具有良好的价值。Objective To analyze the predictive value of cardiac troponin Ⅰ(cTnⅠ), high sensitivity C-reactive protein(hs-CRP), and N-terminal brain natriuretic peptide precursor(NT-proBNP) for major adverse cardiovascular events(MACE) in patients with acute ST-segment elevation myocardial infarction(STEMI) after percutaneous coronary intervention(PCI). Methods From October 2017 to May 2021, 77 patients with STEMI who received PCI and treated successfully in Tongling Municipal Hospital were selected. According to whether MACE occurred within six months after surgery, they were divided into occurrence group(15 cases) and non-occurrence group(62 cases). Serum levels of cTnⅠ,hs-CRP, and NT-proBNP were detected in all patients before PCI. Logistic multivariate regression was used to analyze risk factors, and the receiver operating characteristic(ROC) curve was used to analyze the predictive value. Results The age, proportion of pathological vessels≥2 cases, b-type natriuretic peptide, serum cTnI, hs-CRP, and NT-proBNP levels in the occurrence group were higher than those in the non-occurrence group(P < 0.05). Logistic multivariate analysis showed that age(OR = 3.271, 95%CI:1.346-7.949, P < 0.05) and proportion of pathological vessels≥2 cases(OR = 3.463, 95% CI:0.425-8.415, P < 0.05), preoperative serum cTnI level(OR = 2.766, 95% CI:1.142-6.747, P <0.05), preoperative serum hs-CRP level(OR = 2.757, 95% CI:1.134-6.699, P < 0.05), and preoperative serum NT-proBNP level(OR = 3.846, 95%CI: 1.582-9.347, P <0.05) were the influencing factors of MACE in STEMI patients within six months after PCI. ROC curve results showed that preoperative serum cTnI, hS-CRP, and NT-proBNP levels predicted the AUC values of MACE six months after PCI in STEMI patients were 0.811, 0.681 and 0.718, respectively. Conclusion The serum levels of cTnI, hs-CRP, and NT-proBNP have good value in predicting the occurrence of MACE in STEMI patients after PCI.

关 键 词：心肌肌钙蛋白Ⅰ 高敏-C反应蛋白 N末端脑钠肽前体 经皮冠脉介入术 主要心血管不良事件 急性ST段抬高型心肌梗死 预测价值 

分 类 号：R541[医药卫生—心血管疾病]