血清sST2和PCT对急性心肌梗死经皮冠状动脉介入术后低灌注风险评估价值  

Evaluation value of serum sST2 and PCT for hypoperfusion risk in acute myocardial infarction after PCI

作　　者：李盼盼 LI Panpan(Heart Intensive Care Unit,Shangqiu First People's Hospital,Shangqiu 476000,China)

机构地区：[1]商丘市第一人民医院心脏重症监护室,河南商丘476000

出　　处：《社区医学杂志》2023年第6期288-292,共5页Journal Of Community Medicine

摘　　要：目的 探讨血清可溶性生长刺激表达因子2蛋白(sST2)、降钙素原(PCT)在急性心肌梗死(AMI)患者经皮冠状动脉介入治疗手术(PCI)后低灌注风险的评估价值。方法 选取2020-10-01-2021-12-01商丘市第一人民医院收治的132例AMI患者为研究对象。根据接受PCI术后冠状动脉血流分级情况,将其分为正常灌注组(n=84)及低灌注组(n=48),比较2组一般资料、PCI手术情况、基础疾病、入院时sST2以及PCT水平。采用多因素logistic回归分析以及受试者工作特征(ROC)曲线分析上述指标与AMI患者PCI术后出现低灌注的关联性。结果 单因素分析结果显示,年龄>60岁、有糖尿病史、分次PCI术、左侧主干+3支病变、高水平sST2及PCT组患者出现术后低灌注比例更高,差异有统计学意义,均P<0.05。多因素logistic回归分析结果显示,患者入院时高水平的sST2及PCT、分次PCI术、左主干+3支病变为引发PCI术后低灌注的独立危险因素,均P<0.05。ROC曲线分析显示,入院时sST2、PCT对PCI术后心肌低灌注的预测界值分别为22.75 ng/mL、0.80 ng/L;ROC曲线下面积(AUC)分别为0.739、0.962。结论 AMI患者sST2及PCT水平与PCI术后发生低灌注存在关联性,值得临床上借鉴应用。Objective To explore the evaluation value of serum soluble growth-stimulation expressed gene protein 2(sST2) and procalcitonin(PCT) for hypoperfusion risk in patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI).Methods A total of 132 patients with AMI admitted to Shangqiu First People’s Hospital from October 1,2020 to December 1,2021 were selected as the study subjects.According to the grading of coronary blood flow after PCI,they were divided into normal perfusion group(n=84) and hypoperfusion group(n=48).The general data, PCI situations, underlying diseases, levels of sST2 and PCT at admission were compared between the two groups.The evaluation value of the above indexes for hypoperfusion risk for patients with AMI after PCI was analyzed by multivariate Logistic regression analysis and receiver operating characteristic(ROC) curves.Results The proportion of postoperative hypoperfusion cases in patients over 60 years old, with a history of diabetes, fractionated PCI,left main +3 vessel diseases, high level of sST2 and PCT groups was significantly higher(P<0.05).The results of multivariate logistic regression analysis showed that high-level sST2 and PCT,fractionated PCI,left main +3 vessel lesions at admission were independent risk factors of hypoperfusion after PCI(P<0.05).ROC curves showed that the best cut-off values and area under the ROC curve(AUC) values of sST2 and PCT for predicting myocardial hypoperfusion after PCI were(22.75 ng/mL,0.80 ng/L) and(0.739,0.962),respectively.Conclusion The levels of sST2 and PCT are significantly correlated with hypoperfusion in AMI patients after PCI,which is worthy of reference and application by clinical medical workers.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗手术 可溶性生长刺激表达因子2蛋白 降钙素原 风险评估 

分 类 号：R542.22[医药卫生—心血管疾病]