STEMI患者血清半乳糖凝集素3水平与再灌注室性心律失常及预后的关系研究  

Relationship between serum galectin-3 levels and reperfusion ventricular arrhythmia and prognosis in STEMI patients

作　　者：夏文菁[1] 闫中峰 Xia Wenjing;Yan zhongfeng(Emergency Department,Aviation General Hospital,Beijing 100012,China)

机构地区：[1]航空总医院急诊科,北京100012

出　　处：《广西医科大学学报》2022年第11期1747-1754,共8页Journal of Guangxi Medical University

基　　金：北京市科技计划项目(No.Z14110700251409)。

摘　　要：目的:探讨ST段抬高型心肌梗死(STEMI)患者血清半乳糖凝集素3(Gal-3)与再灌注室性心律失常及经皮冠状动脉介入治疗(PCI)术后不良心血管事件(MACEs)的关系。方法:选择2016年1月至2017年2月在本院成功行PCI的428例STEMI患者作为研究对象,根据是否发生再灌注室性心律失常将患者分为无室性心律失常组和室性心律失常组。采用酶联免疫吸附试验测定入院时血清Gal-3水平,采用Pearson或Spearman相关系数法分析血清Gal-3与再灌注室性心律失常及MACEs的相关关系,采用二元Logistic和COX风险比例回归模型分析三者关系,采用受试者工作特征(ROC)曲线评估三者预测效能。结果:室性心律失常组患者TC、HDL-C、NT-proBNP、cTnI、LVEF和血清Gal-3水平均高于无室性心律失常组,高血压史、糖尿病史、LDL-C、LAD、LVEDD、LVESD、LVEDV、LVESV、LVM均低于无室性心律失常组(均P<0.05),血清Gal-3水平和UA、NT-proBNP呈正相关关系,与Cr呈负相关关系(P<0.05),血清Gal-3水平预测再灌注室性心律失常及MACEs的ROC曲线下面积分别为0.906(95%CI:0.865~0.948)、0.756(95%CI:0.699~0.814),对应截断值分别为8.960、7.630,特异度分别为86.2%、80.4%,敏感度分别为85.0%、68.5%;经多因素Logistic回归分析,血清Gal-3>9.293 ng/mL是再灌注室性心律失常的危险因素(P<0.05);经COX风险比例回归分析,血清Gal-3是患者MACEs发生风险的影响因素(P<0.05)。结论:血清Gal-3水平升高与患者再灌注室性心律失常及术后MACEs发生高风险有关,有望成为预测再灌注室性心律失常及MACEs发生的血清生物标志物。Objective:To investigate the relationship between serum galactose agglutinin 3(Gal-3)and reperfusion ventricular arrhythmias and adverse cardiovascular events(MACEs)after percutaneous transluminal coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STEMI).Methods:A total of 428 STEMI patients who successfully underwent PCI in our hospital from January 2016 to February 2017 were selected as the study subjects and the patients were divided into non-ventricular arrhythmia group and ventricular arrhythmia group according to the occurrence of reperfusion ventricular arrhythmias.Serum Gal-3 levels at admission were determined by enzyme-linked immunosorbent assay,the correlation between serum Gal-3 and reperfusion ventricular arrhythmia and MACEs was analyzed by Pearson or Spearman correlation coefficient method,the relationship between them was analyzed by binary Logistic and COX proportional regression models and receiver operating characteristic(ROC)curve was used to evaluate the predictive efficiency of them.Results:The levels of TC,HDL-C,NT-proBNP,cTnI,LVEF and serum Gal-3 in patients with ventricular arrhythmia group were higher than those in patients in the non-ventricular arrhythmia group.The history of hypertension,diabetes,LDL-C,LAD,LVEDD,LVESD,LVEDV,LVESV and LVM were lower than those in patients in the non-ventricular arrhythmia group(all P<0.05).Serum Gal-3 levels were positively correlated with UA and NT-proBNP,and negatively correlated with Cr(P<0.05).The areas under ROC curve of serum Gal-3 levels for predicting the reperfusion ventricular arrhythmias and MACEs were 0.906(95%CI:0.865-0.948)and 0.756(95%CI:0.699-0.814),corresponding truncation values were 8.960 and 7.630,specificities were 86.2%and 80.4%and sensitivities were 85.0%and 68.5%.Multivariate Logistic regression analysis showed that serum Gal-3>9.293 ng/mL was a risk factor for reperfusion ventricular arrhythmia(P<0.05).COX proportional regression analysis showed that serum Gal-3 was an influential factor in th

关 键 词：血清半乳糖凝集素3 ST段抬高型心肌梗死 室性心律失常 不良心血管事件 

分 类 号：R541.7[医药卫生—心血管疾病]