Csub、BNP对急性心肌梗死患者PCI术后主要不良心血管事件的预测价值  

Prognostic value of Csub and BNP for major adverse cardiovascular events after PCI in patients with acute myocardial infarction

作　　者：黄锡通 黄大伟 林俊亮 高子弟 陈时强 张孝兵 张强 陈苗 HUANG Xitong;HUANG Dawei;LIN Junliang;GAO Zidi;CHEN Shiqiang;ZHANG Xiaobing;ZHANG Qiang;CHEN Miao(Department of Emergency,Yuhuan People's Hospital,Yuhuan 317600,China;不详)

机构地区：[1]玉环市人民医院急诊科,317000 [2]玉环市人民医院检验科,317000

出　　处：《心电与循环》2023年第2期122-125,130,共5页Journal of Electrocardiology and Circulation

基　　金：浙江省医药卫生科技计划项目(2019KY794)。

摘　　要：目的探讨血清ATP合酶C亚基(Csub)、脑钠肽(BNP)对急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后主要不良心血管事件(MACE)的预测价值。方法选取2019年5月至2020年12月在玉环市人民医院行急诊PCI的59例AMI患者为研究对象,术后1年内发生MACE 15例(MACE组),未发生MACE 44例(无MACE组)。比较有、无MACE患者临床资料,分析PCI术后发生MACE的影响因素,同时采用ROC曲线分析这些影响因素对PCI术后发生MACE的预测效能。结果MACE组年龄、血清BNP水平均明显大于无MACE组(均P<0.05);两组患者在性别、发病至就诊时间、左心室射血分数、呼气末二氧化碳、高血压、糖尿病、ST段抬高心肌梗死、血栓抽吸、Csub、肌钙蛋白T、D-二聚体、血肌酐、中性粒细胞与淋巴细胞计数比值、Gensini评分、冠状动脉植入支架总长度等方面比较,差异均无统计学意义(均P>0.05)。将上述P<0.05的2个因素(年龄、BNP)以及P值接近于0.05的2个因素(Csub、冠状动脉植入支架总长度)纳入Cox多因素回归分析,结果显示Csub(HR=1.003)、BNP(HR=1.002)是AMI患者PCI术后发生MACE的影响因素(均P<0.05)。Csub、BNP及两者联合预测AMI患者PCI术后发生MACE的AUC、灵敏度、特异度分别为0.664、0.733、0.705,0.799、0.733、0.841以及0.779、0.533、0.955。结论行急诊PCI的AMI患者早期血清Csub和(或)BNP水平越高,术后1年内发生MACE的风险越大。Objective To investigate the predictive value of serum ATP synthase C subunit(Csub)and brain natriuretic peptide(BNP)for major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods A total of 59 patients with AMI who underwent emergent PCI in Yuhuan People's Hospital from May 2019 to December 2020 were included,with 15 cases of MACE occurring within 1 year after PCI(MACE group),and 44 cases without MACE(non-MACE group).The clinical data of these patients were compared to analyze the influencing factors for MACE occurrence after PCI,and the ROC curves were used to analyze the predictive efficacy of these influencing factors for MACE after PCI.Results Age and serum BNP levels were significantly higher in the MACE group than in the non-MACE group(all P<0.05).There were no statistically significant differences between the two groups in terms of gender,the time from onset to visit,left ventricular ejection fraction,end-expiratory carbon dioxide,hypertension,diabetes mellitus,ST-segment elevation myocardial infarction,thrombus aspiration,Csub,troponin T,D-dimer,serum creatinine,neutrophil-to-lymphocyte count ratio,Gensini score,and total length of intracoronary stent(all P>0.05).The above two factors with P<0.05(age,BNP)and two factors with P values close to 0.05(Csub,total length of intracoronary stent)were included in Cox multivariate regression analysis,which showed that Csub(HR=1.003)and BNP(HR=1.002)were the influential factors in the occurrence of MACE in AMI patients after PCI(both P<0.05).Respectively,the AUC,sensitivity and specificity of Csub,BNP and the combination of both predicting MACE after PCI in AMI patients were 0.664,0.733,0.705 and 0.799,0.733,0.841 and 0.779,0.533,0.955.Conclusion The higher the early serum Csub and/or BNP levels in AMI patients undergoing emergent PCI,the greater the risk of MACE within 1 year after PCI.

关 键 词：ATP合酶C亚基 脑钠肽 急性心肌梗死 经皮冠状动脉介入 主要不良心血管事件 

分 类 号：R542.22[医药卫生—心血管疾病]