血清PAI-1、RBP4水平对急性ST段抬高型心肌梗死患者PCI后无复流的预测价值  

Predictive value of serum PAI-1 and RBP4 levels for patients with STEMI without reflow after PCI

作　　者：刘明 张阳阳 谭伟 LIU Ming;ZHANG Yangyang;TAN Wei(Department of Cardiovascular Medicine,Suqian First People's Hospital,Suqian 223800,China)

机构地区：[1]宿迁市第一人民医院心血管内科,江苏宿迁223800

出　　处：《山东医药》2023年第16期22-25,30,共5页Shandong Medical Journal

基　　金：江苏省卫生健康委医学科研立项项目(S2020089)。

摘　　要：目的探讨血清纤溶酶原激活物抑制剂1(PAI-1)、视黄醇结合蛋白4(RBP4)水平对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)后无复流的预测价值。方法选取129例STEMI患者为STEMI组,根据PCI后心肌梗死溶栓治疗血流分级分为无复流组38例和复流组91例,另选取同期55例体检健康者为对照组。收集STEMI患者临床资料,采用酶联免疫吸附法检测血清PAI-1、RBP4。采用受试者工作特征(ROC)曲线分析血清PAI-1、RBP4水平对STEMI患者PCI后无复流的预测价值。结果与对照组比较,STEMI组血清PAI-1、RBP4水平升高(P均<0.05)。与复流组比较,无复流组血清PAI-1、RBP4水平升高(P均<0.05)。多因素Logistic回归分析结果显示,年龄增加和低密度脂蛋白胆固醇、PAI-1、RBP4升高为STEMI患者PCI后无复流的独立危险因素(P均<0.05),左心室射血分数升高为保护因素(P<0.05)。ROC曲线分析显示,血清PAI-1、RBP4水平预测STEMI患者PCI后无复流的曲线下面积大于PAI-1、RBP4单独预测(P均<0.05)。结论STEMI患者血清PAI-1、RBP4水平升高与PCI后无复流有关,血清PAI-1联合RBP4预测PCI后无复流的价值较高。Objective To investigate the predictive value of serum plasminogen activator inhibitor-1(PAI-1)and retinol-binding protein 4(RBP4)levels for patients with acute ST-segment elevation myocardial infarction(STEMI)with⁃out reflow after percutaneous coronary intervention(PCI).Methods Totally 129 STEMI patients were selected as the STEMI group.According to the blood flow grading of thrombolysis therapy after PCI,they were divided into the no-reflow group(38 cases)and the reflow group(91 cases),and 55 healthy subjects were selected as the control group during the same period.Clinical data of STEMI patients were collected,and serum levels of PAI-1 and RBP4 were detected by en⁃zyme-linked immunosorbent assay.The predictive value of serum PAI-1 and RBP4 levels in patients with STEMI without reflow after PCI was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the serum levels of PAI-1 and RBP4 in STEMI group increased(all P<0.05).Compared with the reflow group,the serum levels of PAI-1 and RBP4 in no-reflow group increased(all P<0.05).Multivariate Logistic regression analysis showed that the increase of age and the increase of LDL cholesterol,PAI-1 and RBP4 were independent risk factors for noreflow after PCI in STEMI patients(all P<0.05),and the increase of left ventricular ejection fraction was a protective fac⁃tor(P<0.05).ROC curve analysis showed that the area under the curve of serum PAI-1 and RBP4 levels was greater than that of PAI-1 and RBP4 alone in predicting no-reflow of STEMI patients after PCI(both P<0.05).Conclusion The in⁃creased serum levels of PAI-1 and RBP4 in STEMI patients are associated with no-reflow after PCI,and the serum PAI-1 combined with RBP4 has a high value in predicting no-reflow after PCI.

关 键 词：急性ST段抬高型心肌梗死 经皮冠状动脉介入术 纤溶酶原激活物抑制剂1 视黄醇结合蛋白4 无复流 

分 类 号：R542.2[医药卫生—心血管疾病]