血清Syndecan-4、TIMP-1与STEMI患者冠状动脉病变血管支数、超声心动图参数的关系  

The relationship between serum Syndecan-4, TIMP-1 and the number of coronary artery lesions and echocardiographic parameters in STEMI patients

作　　者：杨晓妍 唐玉洁 梁颖 唐念中 张敏 Yang Xiaoyan;Tang Yujie;Liang Ying;Tang Nianzhong;Zhang Min(Department of Ultrasound,The First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;不详)

机构地区：[1]海军军医大学第一附属医院健康管理中心检验科,上海200433 [2]海军军医大学第一附属医院心内科,上海200433 [3]海军军医大学第一附属医院超声科,上海200433

出　　处：《疑难病杂志》2023年第3期241-246,共6页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的 分析多配体蛋白聚糖4(Syndecan-4)、基质金属蛋白酶抑制剂-1(TIMP-1)与ST段抬高型心肌梗死(STEMI)患者冠状动脉病变血管支数、超声心动图参数的关系。方法 选取2021年1—12月海军军医大学第一附属医院心内科诊治的STEMI患者67例作为STEMI组,将同期确诊为慢性心绞痛的72例患者作为慢性心绞痛组,另选取同期冠状动脉造影结果正常的50例患者作为对照组。依据冠状动脉造影检查Gensini积分结果将STEMI患者再分为A亚组25例(0~20分,1支血管病变)、B亚组23例(21~40分,2支血管病变)和C亚组19例(40分以上,3支及以上血管病变)。比较各组血清Syndecan-4和TIMP-1水平,超声心动图参数[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、舒张早期二尖瓣血流速度/舒张晚期二尖瓣血流速度(E/A)]、心肌缺血指标[心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)]、心力衰竭指标[N末端脑钠肽前体(NT-proBNP)],Pearson法分析STEMI患者血清Syndecan-4、TIMP-1水平与Gensini积分和超声心动图参数之间的关系,受试者工作特征曲线(ROC)分析血清Syndecan-4、TIMP-1预测STEMI的价值。结果 血清Syndecan-4、TIMP-1及LVESD水平比较,STEMI组>慢性心绞痛组>对照组(F=253.293、67 612.917、20.563,P均<0.001);LVEF水平比较,STEMI组<慢性心绞痛组<对照组(F=28.194,P<0.001),3组LVEDD、LVEDV、LVESV和E/A比较差异无统计学意义(P>0.05);STEMI组cTnI、CK-MB和NT-proBNP水平高于慢性心绞痛组和对照组(F=1 809.343、1 352.872、2 289.851,P均<0.001),慢性心绞痛组cTnI和NT-proBNP水平高于对照组(P<0.05);Gensini积分比较,C亚组>B亚组>A亚组(F=951.801,P<0.001);A、B、C亚组患者血清Syndecan-4、TIMP-1及LVESD水平依次升高(F/P=4.405/0.016、2 965.986/<0.001、3.520/0.035),而LVEF水平依次降低(F/P=5.385/0.007),3亚组LVEDD、LVEDV、LVESV�Objective To analyze the relationship between multi-ligand proteoglycan-4(Syndecan-4), matrix metalloproteinase-1(TIMP-1) and the number of coronary artery lesions and echocardiographic parameters in patients with ST-segment elevation myocardial infarction(STEMI). Methods Sixty-seven patients with STEMI diagnosed and treated by the Department of Cardiology of the First Affiliated Hospital of the Naval Military Medical University from January 2021 to December 2021 were selected as the STEMI group, 72 patients with chronic angina pectoris diagnosed at the same time were selected as the chronic angina pectoris group, and 50 patients with normal coronary angiography results at the same time were selected as the control group. According to the Gensini score of coronary angiography, STEMI patients were divided into 25 patients in subgroup A(0-20 points, 1 vessel lesion), 23 patients in subgroup B(21-40 points, 2 vessel lesions) and 19 patients in subgroup C(more than 40 points, 3 vessel lesions and more). Compare the levels of serum Syndecan-4 and TIMP-1, the parameters of echocardiography(left ventricular ejection fraction(LVEF), left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter(LVESD), left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV), early diastolic mitral flow velocity/late diastolic mitral flow velocity(E/A) Myocardial ischemia index [cardiac troponin I(cTnI), creatine kinase isoenzyme MB(CK-MB)], heart failure index [N-terminal B-type natriuretic peptide(NT-proBNP)], Pearson method was used to analyze the relationship between serum Syndecan-4 and TIMP-1 levels and Gensini score and echocardiographic parameters in patients with STEMI, and the value of serum Syndecan-4 and TIMP-1 in predicting STEMI was analyzed by subject working characteristic curve(ROC). Results Compared with the serum levels of Syndecan-4, TIMP-1 and LVESD, STEMI group>chronic angina pectoris group>control group(F=253.293, 67 612.917, 20.563,P<0.001). LVEF level: STEM

关 键 词：ST段抬高型心肌梗死 多配体蛋白聚糖4 基质金属蛋白酶抑制剂-1 冠状动脉病变血管支数 超声心动图参数 相关性 

分 类 号：R542.2[医药卫生—心血管疾病]