血清c MyBP-C、Myo、Apo CⅢ水平联合预测AMI患者择期PCI术后MACE发生的价值  

The value of serum c MyBP-C,Myo and Apo CⅢlevels combined to predict the occurrence of MACE after elective PCI in AMI patients

作　　者：陈晨 张爱霞 黄颖[1] CHEN Chen;ZHANG Aixia;HUANG Ying(Xuzhou Central Hospital,Xuzhou 221009,Jiangsu,China)

机构地区：[1]徐州市中心医院,江苏徐州221009

出　　处：《西部医学》2023年第3期416-420,426,共6页Medical Journal of West China

基　　金：徐州市彭城英才-医学青年后备人才项目(XWRCHT20220006)。

摘　　要：目的探讨血清心肌肌球蛋白结合蛋白-C(c MyBP-C)、肌红蛋白(Myo)、脂蛋白CⅢ(Apo CⅢ)水平联合预测急性心肌梗死(AMI)患者择期行经皮冠状动脉介入治疗术(PCI)术后主要不良心血管事件(MACE)发生的价值。方法选取2018年6月—2020年9月我院收治的219例行择期PCI术治疗的AMI患者设为观察组,另选取同期体检的200例健康志愿者为对照组。检测并对比两组血清c MyBP-C、Myo、Apo CⅢ水平,比较观察组不同病变支数患者血清c MyBP-C、Myo、Apo CⅢ水平;依据AMI患者术后12个月内有无MACE发生将其分为MACE组和无MACE组。统计观察组患者PCI术后12个月内MACE发生情况,并对比MACE组、无MACE组血清c MyBP-C、Myo、Apo CⅢ水平;采用Logistic多元回归分析AMI患者择期PCI术后MACE发生的影响因素,并采用受试者工作特征(ROC)曲线分析血清c MyBP-C、Myo、Apo CⅢ水平单独及联合预测AMI患者择期PCI术后发生MACE的价值。结果观察组血清c MyBP-C、Myo、Apo CⅢ水平高于对照组(P<0.05);观察组多支病变患者血清c MyBP-C、Myo、Apo CⅢ水平均高于单支病变患者(P<0.05);观察组患者PCI术后12个月内MACE发生率为24.77%,MACE组血清c MyBP-C、Myo和Apo CⅢ水平均高于无MACE组(P<0.05);合并糖尿病、发病至PCI治疗时间、病变支数、置入支架数量、入院后血清c MyBP-C、Myo和Apo CIII水平均是AMI患者PCI术后发生MACE的影响因素(P<0.05);血清c MyBP-C、Myo和Apo CⅢ水平三者联合预测AMI患者PCI术后MACE发生的灵敏度、特异度及曲线下面积(AUC)、灵敏度、ACU均高于单独预测(P<0.05),特异度与单独预测相比差异无统计学意义(P>0.05)。结论AMI患者血清c MyBP-C、Myo和Apo CⅢ水平均较正常人群升高,AMI患者择期PCI术后MACE发生率较高,MACE组血清c MyBP-C、Myo和Apo CⅢ水平均高于无MACE组,均为其PCI术后发生MACE的危险因素,且均对AMI患者PCI术后发生MACE均有较好的预测价值,但三者联合预�Objective To investigate the value of cardiac myosin binding protein-C(c MyBP-C),myoglobin(Myo)and apolipoprotein CⅢ(Apo CⅢ)in predicting major adverse cardiovascular events(MACE)after elective percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods 219 AMI patients undergoing elective PCI in our hospital from June 2018 to September 2020 were selected as the study group,and 200 healthy volunteers were selected as the control group in the same period.The levels of serum c MyBP-C,Myo and APO CⅢwere detected and compared between the two groups,and the levels of serum c MyBP-C,Myo and Apo CⅢin patients with different lesion branches in the study group were compared.The incidence of MACE in the study group at 12 months after PCI was counted,and the levels of serum c MyBP-C,Myo,Apo CⅢin the MACE group and non MACE group were compared.Logistic multiple regression was used to analyze the influencing factors of MACE after elective PCI in patients with AMI,and the receiver operating characteristic(ROC)curve analysis of serum c MyBP-C,Myo,Apo CⅢlevels alone and in combination to predict MACE after elective PCI for AMI.Results The levels of serum c MyBP-C,Myo and Apo CⅢin the study group were higher than those in the control group(P<0.05),and the levels of serum c MyBP-C,Myo and Apo CⅢin patients with multi vessel lesions in the study group were higher than those in patients with single vessel lesions(P<0.05).The incidence of MACE within 12 months after PCI in the study group was 24.77%.The levels of serum c MyBP-C,Myo and Apo CⅢin the MACE group were higher than those in the non MACE group(P<0.05).Diabetes mellitus,the time from onset to PCI treatment,number of lesions,the number of stents placed,serum c MyBP-C,Myo and Apo CⅢwere influencing factors for MACE after PCI in AMI patients(P<0.05).The sensitivity,specificity and area under curve(AUC)of serum c MyBP-C,Myo and Apo CⅢlevels combined to predict the occurrence of MACE after PCI in patients with AMI were 98

关 键 词：心肌肌球蛋白结合蛋白-C 脂蛋白CⅢ 肌红蛋白 急性心肌梗死 经皮冠状动脉介入术 主要不良心血管事件 

分 类 号：R542.22[医药卫生—心血管疾病]