血清骨桥蛋白和D-二聚体水平对心肌梗死介入治疗患者预后的影响  

Effect of serum osteopontin and D-dimer levels on prognosis of patients with myocardial infarction undergoing interventional therapy

作　　者：马新豫 MA Xinyu(Department of NO.1 Cardiology,the Central Hospital of Zhumadian,Zhumadian 463000,Henan Province,China)

机构地区：[1]驻马店市中心医院心内一科,河南驻马店463000

出　　处：《新乡医学院学报》2022年第11期1047-1050,1054,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨血清骨桥蛋白(OPN)和D-二聚体(D-D)水平对心肌梗死介入治疗患者预后的影响。方法选择2019年1月至2020年12月驻马店市中心医院收治的268例心肌梗死患者为研究对象。患者均行介入治疗,并于治疗后进行为期12个月的随访。随访期间评估患者预后,并根据预后将患者分为预后不良组(n=60)和预后良好组(n=208)。收集所有患者的临床资料并进行单因素分析,将单因素分析中差异有统计学意义的指标进一步行logistic回归分析影响心肌梗死患者介入治疗预后的因素;绘制决策曲线,分析联合检测血清OPN和D-D水平预测心肌梗死患者介入治疗预后的价值。结果预后不良组与预后良好组患者的性别、年龄、发病至就医时间、饮酒史、吸烟史、舒张压、收缩压、空腹血糖、左心室射血分数及低密度脂蛋白胆固醇水平比较差异无统计学意义(P>0.05)。预后不良组患者血清中三酰甘油(TG)、总胆固醇(TC)、肌钙蛋白Ⅰ(cTnI)、OPN、D-D水平显著高于预后良好组,高密度脂蛋白胆固醇(HDL-C)水平显著低于预后良好组(P<0.05)。Logistic回归分析结果显示,TG、TC、cTnI、OPN、D-D水平是心肌梗死患者介入治疗预后不良的影响因素(P<0.05),HDL-C水平与心肌梗死患者介入治疗的预后无关(P>0.05)。决策曲线结果显示,阈值在0.00~0.92时,联合检测血清OPN和D-D水平预测心肌梗死患者介入治疗预后不良净收益率高于单独血清OPN或D-D检测。结论血清OPN和D-D水平是心肌梗死介入治疗患者预后的影响因素,联合检测血清OPN和D-D水平对心肌梗死患者介入治疗预后不良有较高的预测价值。Objective To investigate the effect of serum osteopontin(OPN)and D-dimer(D-D)levels on the prognosis of patients with myocardial infarction undergoing interventional therapy.Methods A total of 268 patients with myocardial infarction admitted to the Central Hospital of Zhumadian from January 2019 to December 2020 were selected as the study subjects.All patients received interventional therapy and were followed up for 12 months after treatment.The prognosis of patients were assessed during follow-up,and the patients were divided into the poor prognosis group(n=60)and the good prognosis group(n=208)according to the prognosis.The clinical data of all patients were collected and analyzed by single factor analysis.The indexes with statistically significant difference in single factor analysis were further performed logistic regression to analyze the factors influencing the prognosis of patients with myocardial infarction undergoing interventional therapy.The decision curve was drawed to analyze the value of combining detection of serum OPN and D-D levels in predicting the prognosis of patients with myocardial infarction undergoing interventional therapy.Results There was no significant difference in sex,age,time from onset to medical treatment,drinking history,smoking history,diastolic blood pressure,systolic blood pressure,fasting blood glucose,left ventricular ejection fractions and low density lipoprotein between the poor prognosis group and the good prognosis group(P>0.05).The serum levels of triglyceride(TG),total cholesterol(TC),cardiac troponin I(cTnI),OPN,D-D of patients in the poor prognosis group were significantly higher than those in the good prognosis group,while the serum high density liptein cholesterol(HDL-C)level was significantly lower than that in the good prognosis(P<0.05).Logistic regression analysis showed that the levels of TG,TC,cTnI,OPN and D-D were the influencing factors for poor prognosis of patients with myocardial infarction undergoing interventional therapy(P<0.05);the level of HDL-C was

关 键 词：心肌梗死 介入治疗 骨桥蛋白 D-二聚体 预后 

分 类 号：R542.22[医药卫生—心血管疾病]