血清降钙素原D二聚体C反应蛋白脑钠肽对急性心肌梗死患者经皮冠状动脉介入术后心功能不全的预测价值  

Predictive value of serum PCT D-D CRP and BNP for cardiac insufficiency after PCI in patients with acute myocardial infarction

作　　者：崔绍彬 Cui Shaobin(Department of Laboratory,First Affiliated Hospital of Nanyang Medical College,Nanyang Henan 473000,China)

机构地区：[1]河南省南阳医学高等专科学校第一附属医院检验科,河南南阳473000

出　　处：《实用医技杂志》2023年第3期193-197,共5页Journal of Practical Medical Techniques

摘　　要：目的 探讨急性心肌梗死(AMI)经皮冠状动脉介入术(PCI)后心功能不全患者血清降钙素原(PCT)、D-二聚体(D-D)、脑钠肽(BNP)、C反应蛋白(CRP)水平,并分析其对心功能不全的预测价值。方法选取2020年1月至2022年1月于南阳医学高等专科学校第一附属医院行PCI的200例AMI患者为研究对象,根据PCI后6个月是否发生心功能不全分为发生组56例、未发生组144例。分析2组血清PCT、D-D、CRP、BNP水平与心功能指标、Killip分级相关性,分析其对PCI后心功能不全的预测价值。Logistic回归模型分析PCI后心功能不全的影响因素。结果 发生组术后1个月血清PCT、D-D、CRP、BNP水平分别为(1.93±0.54)μg/L、(2 003±248)ng/ml、(55±15)mg/L、(886±215)ng/L,均高于未发生组的(1.12±0.27)μg/L、(1 406±229)ng/ml、(26±6)mg/L、(337±96)ng/L(t=14.069、16.181、19.383、24.939,P均<0.05);血清各指标与肌钙蛋白(cTnI)、肌酸激酶同工酶(CK-MB)、Killip分级呈正相关,其与左心室射血分数(LVEF)呈负相关,且为心功能不全的危险因素(P<0.05);术后1个月血清各指标联合预测PCI后心功能不全的曲线下面积(AUC)大于单项预测(P<0.05)。结论 血清PCT、D-D、CRP、BNP对AMI患者PCI后心功能不全具有一定预测价值。Objective To investigate the levels of serum calcitoninogen(PCT),D-dimer(D-D),brain natriuretic peptide(BNP)and C-reactive protein(CRP)in patients with cardiac insufficiency after percutaneous coronary intervention(PCI)for acute myocardial infarction(AMI)and to analyze their predictive value for cardiac insufficiency.Methods A total of 200 patients with AMI who underwent PCI in First Affiliated Hospital of Nanyang Medical College between January 2020 and January 2022 were selected for the study,and were divided into 56 cases in the occurrence group and 144 cases in the non-occurrence group according to whether or not cardiac insufficiency occurred 6 months after PCI.The correlation of serum PCT,D-D,CRP and BNP levels and cardiac function indexes and Killip classification was analyzed in both groups to determine the predictive value of post-PCI cardiac insufficiency.Logistic regression model was used to analyze the influencing factors of post-PCI cardiac insufficiency.Results Serum PCT,D-D,CRP,and BNP levels in the occurrence group were(1.93±0.54)μg/L,(2003±248)ng/mL,(55±15)mg/L,and(886±215)ng/L,respectively,at 1 month after the operation,which were higher than those in the non-occurrence group(1.12±0.27)μg/L,(1406±229)ng/mL,(26±6)mg/L,and(337±96)ng/L,respectively(t=14.069,16.181,19.383,and 24.939,all P<0.05);serum indicators were positively correlated with cTnI,CK-MB and Killip classification,and their correlation with LVEF was negatively correlated and was a risk factor for cardiac insufficiency(P<0.05);the AUC of the serum indicators combined to predict post-PCI cardiac insufficiency was greater than that of the single prediction at 1 month after the procedure(P<0.05).Conclusion Serum PCT,D-D,CRP,and BNP have certain predictive value for post-PCI cardiac insufficiency in patients with AMI.

关 键 词：急性心肌梗死 C反应蛋白 降钙素原 D-二聚体 脑钠肽 

分 类 号：R542.22[医药卫生—心血管疾病]