血清视黄醇结合蛋白4对ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后主要不良心血管事件的预测价值  

Predictive Value of Serum Retinol Binding Protein 4 for Adverse Cardiovascular Events after Percutaneous Coronary Intervention in ST-segment Elevation Myocardial Infarction Patients

作　　者：李华承 王存宝 李习 文朱琳 LI Huacheng;WANG Cunbao;LI Xiwen;ZHU Lin(Department of Cardiology,Qingyang Second People's Hospital,Qingyang 745000,Gansu,China)

机构地区：[1]庆阳市第二人民医院心血管内科,甘肃庆阳745000

出　　处：《中国分子心脏病学杂志》2022年第5期4903-4910,共8页Molecular Cardiology of China

摘　　要：目的分析血清视黄醇结合蛋白4(RBP4)对ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后主要不良心血管事件(MACE)的预测价值。方法纳入2019年1月至2020年12月接受PCI的332例STEMI患者,另纳入80例非STEMI患者。采用酶联免疫吸附测定法检测血清RBP4水平。随访记录STEMI患者PCI后MACE的发生情况,其中79例发生MACE(MACE组),其余253例未发生MACE(非MACE组)。结果MACE组STEMI患者血清RBP4水平高于非MACE组STEMI患者[(44.9±12.1)mg/L比(40.3±10.9)mg/L,t=3.202,P=0.002]。STEMI患者血清RBP4水平高于非STEMI患者[(43.0±10.3)mg/L比(19.7±8.1)mg/L,t=18.810,P<0.001]。受试者操作特征(ROC)曲线显示,血清RBP4水平诊断STEMI的曲线下面积为0.946(95%CI:0.925~0.966)。Spearman相关分析结果显示,血清RBP4水平与STEMI患者左心室舒张末期直径(LVEDD)、左心室收缩末期直径(LVESD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)呈显著正相关(r=0.113、0.136、0.113、0.136,P<0.05),与STEMI患者室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左心室射血分数(LVEF)呈显著负相关(r=-0.163、-0.115、-0.123,P<0.05)。血清RBP4水平>46.0 mg/L的STEMI患者MACE发生率为31.9%(53/166),低于血清RBP4水平≤46.0 mg/L的STEMI患者MACE发生率为15.7%(26/166),且差异有统计学意义(P<0.05)。Kaplan-Meier生存曲线显示,血清RBP4水平>46.0 mg/L的STEMI患者无MACE发生的生存期短于血清RBP4水平≤46.0 mg/L的STEMI患者,且差异有统计学意义(χ^(2)=11.445,P<0.001)。多因素Cox回归分析结果显示,血清RBP4水平>46.0 mg/L是STEMI患者PCI后MACE的独立危险因素(P<0.05)。结论入院时血清RBP4水平升高是STEMI患者急诊PCI后发生MACE的有力预测因子。Objective To analyze the predictive value of serum retinol binding protein 4(RBP4)in major adverse cardiovascular events(MACE)in patients with ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods Totally 332 patients with STEMI who received PCI stent implantation in our hospital from January 2019 to December 2020 were enrolled,and 80 healthy controls were included.Serum RBP4 level was detected by enzyme-linked immunosorbent assay.The occurrence of MACE in STEMI patients after PCI was followed up and recorded.The patients with MACE were included in the MACE group(n=79),and the remaining patients were included in the nonMACE group(n=253).Results The serum RBP4 level in MACE group was significantly higher than that in non-MACE group[(44.9±12.1)mg/L vs(40.3±10.9)mg/L,t=3.202,P=0.002].Serum RBP4 level in STEMI patients was higher than that in healthy controls[(43.0±10.3)mg/L vs(19.7±8.1)mg/L,t=18.810,P<0.001].According the receiver operating characteristic,the area under the curve of serum RBP4 level in differential diagnosis of STEMI was 0.946(95%CI:0.925-0.966).Spearman rank correlation analysis showed that serum RBP4 level was significantly positively correlated with left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular end diastolic volume(LVEDV)and left ventricular end systolic volume(LVESV)(r=0.113,0.136,0.113,0.136,P<0.05).Interventricular septum thickness(IVST),left ventricular posterior wall thickness(LVPWT)and left ventricular ejection fraction(LVEF)were significantly negatively correlated(r=-0.163,-0.115,-0.123,P<0.05).The incidence of MACE was significantly lower in patients with serum RBP4 level>46.0 mg/L(31.9%vs 15.7%,P<0.05),and the survival time without MACE was also lower(χ^(2)=11.445,P<0.001).Univariate and multivariate Cox regression analysis showed that serum RBP4 level>46.0mg/L was an independent predictor of MACE after PCI in STEMI patients(P<0.05).Conclusions Elevated serum RBP4 level a

关 键 词：视黄醇结合蛋白4 ST段抬高型心肌梗死 经皮冠状动脉介入治疗 主要不良心血管事件 预后 

分 类 号：R542.22[医药卫生—心血管疾病]