D-二聚体、GDF-15、HSP对AMI患者PCI术后并发MACE的预测价值及与预后的关系  

The predictive value and prognosis of D-Dimer,GDF-15 and HSP70 in patients with AMI complicated with MACE after PCI

作　　者：常丽辉 王绍伟[1] 赵伟波 CHANG Lihui;WANG Shaowei;ZHAO Weibo(Department of Cardiology,Handan Central Hospital,Handan,Hebei 0560008,China;Department of Pre-hospital Emergency Care,Handan Central Hospital,Handan,Hebei 0560008,China)

机构地区：[1]邯郸市中心医院心内科,河北邯郸0560008 [2]邯郸市中心医院院前急救,河北邯郸0560008

出　　处：《国际检验医学杂志》2023年第14期1748-1751,1755,共5页International Journal of Laboratory Medicine

基　　金：邯郸市科学技术研究与发展计划项目(22422083022ZC)。

摘　　要：目的探讨血清D-二聚体、生长分化因子-15(GDF-15)、主要热休克蛋白(HSP70)指标水平对急性心肌梗死(AMI)患者接受经皮冠状动脉介入术(PCI)并发主要不良心血管事件(MACE)的预测价值及与患者预后的关系。方法选取2020年10月至2021年10月期间本院收治的AMI患者共132例作为本研究对象,所有患者均在本院接受PCI术,记录并对比各组患者心脏相关指标值及血清D-二聚体、GDF-15、HSP70值;对所有患者展开为期30 d的随访调查工作来观察患者是否发生MACE,对比不同预后患者血清各指标水平情况,采用ROC曲线分析血清各指标对AMI患者PCI术后发生MACE的预测效能,采用Spearman相关系数分析血清各指标与AMI患者PCI术后预后的相关性。结果随着患者心功能级别的升高,其左室短轴缩短率(FS)、左室射血分数(LVEF)水平呈现明显降低趋势,而左室舒张末期内径(LVEDD)、左房内径(LAD)水平均呈现明显升高趋势(P<0.05);随着患者心功能级别的升高,患者血清D-二聚体、GDF-15及HSP70值均呈现明显升高态势(P<0.05);MACE组患者血清D-二聚体、GDF-15及HSP70值均明显高于非MACE组(P<0.05);经ROC曲线分析显示血清D-二聚体、GDF-15及HSP70指标对AMI患者PCI术后发生MACE的预测效能均较高,而三项指标联合检测的效能更高(AUC=0.893);采用Spearman相关系数分析显示,血清D-二聚体、GDF-15及HSP70指标均与AMI患者发生MACE具有明显正相关性(r=0.712、0.662、0.673,P<0.05)。结论血清D-二聚体、GDF-15、HSP70可反馈AMI患者术后心功能,上述三项指标联合检测对患者PCI术后并发MACE具有较高的预测效能,对评估患者预后有积极效用。Objective To investigate the predictive value of serum D-Dimer,growth differentiation factor-15(GDF-15)and major heat shock protein(HSP70)on adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)undergoing percutaneous coronary intervention(PCI)and the relationship between the three indexes and the prognosis of patients.Methods A total of 132 patients with AMI admitted to our hospital from October 2020 to October 2021 were selected as the research objects.All patients underwent PCI in our hospital.The heart-related index values and serum D-Dimer,GDF-15 and HSP70 values of patients in each group were recorded and compared.All patients were followed up for a period of 30 days to observe whether MACE occurred in the patients.The levels of serum indicators in patients with different prognosis were compared.ROC curve was used to analyze the predictive efficacy of serum indicators for MACE in AMI patients after PCI.Spearman correlation coefficient was used to analyze the correlation between serum indexes and the prognosis of AMI patients after PCI.Results With the increase of cardiac function level,the left ventricular short-axis shortening rate(FS)and left ventricular ejection fraction(LVEF)decreased significantly,while the left ventricular end-diastolic diameter(LVEDD)and left atrial diameter(LAD)all increased significantly(P<0.05).With the increase of cardiac function level,the serum D-Dimer,GDF-15 and HSP70 values of patients were all significantly increased(P<0.05).The serum levels of D-Dimer,GDF-15 and HSP70 in MACE group all increased significantly compared with those in non-MACE group(P<0.05).ROC curve analysis showed that serum D-Dimer,GDF-15 and HSP70 indexes had higher predictive efficacy for MACE after PCI in AMI patients,and the combined detection efficiency of the three indexes was higher(AUC=0.893).Spearman correlation coefficient analysis showed that serum D-Dimer,GDF-15 and HSP70 indexes were significantly positively correlated with MACE in AMI patients(r=0.712,0.662,0.673

关 键 词：急性心肌梗死 D-二聚体 生长分化因子-15 热休克蛋白70 不良心血管事件 

分 类 号：R446.11[医药卫生—诊断学]