血清CyPA、SDF-1及LMR水平与老年ACS患者PCI治疗后再发心肌梗死的相关性  

Correlation of serum CyPA,SDF-1 and LMR levels with recurrent myocardial infarction after PCI in elderly patients with ACS

作　　者：吉思 宴君 陈其敬 吉晓理 吴嘉[2] JI Si;YAN Jun;CHEN Qi-jing(Department of Cardiovascular Medicine,Sanya People's Hospital/West China Sanya Hospital of Sichuan University,Sanya Hainan 572022,China)

机构地区：[1]三亚市人民医院/四川大学华西三亚医院心血管内科,海南三亚572022 [2]中国人民解放军联勤保障部队第九〇八医院病理科,江西南昌330001

出　　处：《临床和实验医学杂志》2023年第4期342-346,共5页Journal of Clinical and Experimental Medicine

基　　金：海南省卫生健康行业科研项目(编号:21A200296)。

摘　　要：目的探讨急性冠脉综合征(ACS)患者血清亲环素A(CyPA)、基质细胞衍生因子-1(SDF-1)、淋巴细胞/单核细胞比值(LMR)的变化与患者经皮冠脉介入术(PCI)后再发心肌梗死的关系。方法回顾性选取2017年1月至2020年1月在三亚市人民医院采取PCI方法治疗且术后24个月内再次发生心肌梗死的患者56例(心肌梗死组)、同期因ACS接受PCI治疗且未发生相关心血管不良事件患者100例作为对照组。对比两组患者术后48 h内的血清CyPA、SDF-1、LMR值,患者的一般临床资料、ACS病情资料、心功能指标等;采用Logistic回归模型综合分析血清CyPA、SDF-1、LMR与患者再发心肌梗死的关系。结果心肌梗死组患者年龄为(67.50±7.10)岁,大于对照组[(64.10±6.80)岁],CyPA、SDF-1及LMR分别为(11.61±2.95)ng/mL、(7.90±2.51)ng/mL、(3.88±0.76),均显著大于对照组[(9.43±2.50)ng/mL、(6.58±1.96)ng/mL、(2.86±0.71)],差异均有统计学意义(P<0.05)。心肌梗死组患者的LVEF%、NT-proBNP、心前壁心肌梗死患者占比、术前靶血管TIMI分级≤Ⅰ级占比、ACS分类中心肌梗死患者占比、术中出现无复流患者占比、术中低血压占比、术中心律失常患者占比为(54.39±4.77)%、(1365.80±308.10)pg/mL、75.00%、78.57%、75.00%、14.29%、16.07%、28.57%,均显著大于对照组[(57.20±4.85)%、(998.10±217.40)pg/mL、57.00%、55.00%、57.00%、3.00%、6.00%、9.00%],差异均有统计学意义(P<0.05)。Logistic回归模型结果显示:患者年龄较大、术前靶血管TIMI分级≤Ⅰ级、术中出现无复流、术中出现心律失常、LVEF降低、CyPA、SDF-1及LMR水平增高是ACS患者PCI后再发心肌梗死的独立危险因素(P<0.05)。结论ACS患者PCI后再发心肌梗死的危险因素很多,CyPA、SDF-1及LMR水平增高会显著增大患者再发心肌梗死的风险。Objective To investigate the relationship between the changes of serum cyclophilin A(CyPA),stromal cell derived factor-1(SDF-1),lymphocyte/monocyte ratio(LMR)and recurrent myocardial infarction after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods In this study,a retrospective study plan was adopted.Fifty-six patients(myocardial infarction group)who were treated by PCI in Sanya People’s Hospital from January 2017 to January 2020 and had myocardial infarction again within 24 months after the operation were selected as the control group,and 100 patients who were treated by PCI for ACS at the same time and had no related adverse cardiovascular events were selected as the control group.The serum CyPA,SDF-1,LMR values,general clinical data,ACS disease data,cardiac function indicators,etc.of the two groups of patients within 48 hours after the operation were compared,Logistic regression model was used to comprehensively analyze the relationship between serum CyPA,SDF-1,LMR and recurrent myocardial infarction.Results The age of patients in MI group were(67.50±7.10)years,which were significantly older than those in control group[(64.10±6.80)years],CyPA,SDF-1 and LMR in MI group were(11.61±2.95)ng/mL,(7.90±2.51)ng/mL and(3.88±0.76),respectively,which were significantly higher than those in control group[(9.43±2.50)ng/mL,(6.58±1.96)ng/mL and(2.86±0.71)],the differences were statistically significant(P<0.05).The LVEF%,NT proBNP,the proportion of patients with anterior wall myocardial infarction,preoperative target vessel TIMI grade≤grade I,central muscle infarction according to ACS classification,no reflow during operation,intraoperative hypotension,and cardiac arrhythmia during operation were(54.39±4.77)%,(1365.80±308.10)pg/mL,75.00%,78.57%,75.00%,14.29%,16.07%,and 28.57%,which were significantly higher than those in the control group[(57.20±4.85)%,(998.10±217.40)pg/mL,57.00%,55.00%,57.00%,3.00%,6.00%,9.00%],and the differences were statistically significant(P<0.

关 键 词：急性冠脉综合征 亲环素A 基质细胞衍生因子-1 淋巴细胞/单核细胞比值 经皮冠脉介入术 心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]