血清NT-proBNP、补体C1q和TIMPs联合超声心动图在STEMI合并HFpEF预测中的临床价值  

Clinical value of serum NT-proBNP,complement C1q,and TIMPs combined with echocardiography in the prediction of STEMI combined with HFpEF

作　　者：马婧宜 杨喜山[1] 秦道铎 MA Jing-yi;YANG Xi-shan;QIN Dao-duo(The First Affiliated Hospital of Henan University of Science and Technology/Clinical College of Henan University of Science and Technology,Luoyang Henan 471003,China)

机构地区：[1]河南科技大学第一附属医院/河南科技大学临床医学院心内科,河南洛阳471003

出　　处：《临床和实验医学杂志》2023年第16期1780-1783,共4页Journal of Clinical and Experimental Medicine

基　　金：河南省科技发展计划项目(编号:182102310502)。

摘　　要：目的探讨血清N端脑钠肽前体(NT-proBNP)、补体C1q和组织金属蛋白酶抑制剂(TIMPs)联合超声心动图在ST段抬高型心肌梗死(STEMI)合并射血分数保留的心力衰竭(HFpEF)预测中的临床价值。方法回顾性选取2021年3月至2022年6月河南科技大学第一附属医院收治的94例STEMI患者,根据是否合并有HFpEF将患者分为HFpEF组(n=38)和非HFpEF组(n=56)。比较两组患者一般临床资料[性别、年龄、体重指数、收缩压、舒张压、高血压、糖尿病、脑卒中病史、心肌梗死病史、吸烟、饮酒、白细胞计数(WBC)、血红蛋白、血小板计数(PLT)、C反应蛋白(CRP)、血肌酐、甘油三酯、尿酸、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖]、NT-proBNP、补体C1q及TIMP-1、TIMP-2水平、超声心动图参数,并分析NT-proBNP、补体C1q、TIMPs、超声心动图参数与STEMI患者是否合并HFpEF的关系,及各指标预测STEMI患者合并HFpEF的价值。结果两组患者性别构成比、体重指数、收缩压、舒张压、高血压、糖尿病、脑卒中病史、饮酒、WBC、血红蛋白、PLT、CRP、血肌酐、甘油三酯、尿酸、HDL-C、LDL-C、左室舒张末期内径(LVDd)、左心室收缩末期内径(LVDs)、室间隔的厚度(IVS)、左室后壁厚度(LVPW)进行比较,差异均无统计学意义(P>0.05)。HFpEF组患者年龄、FPG、NT-proBNP、TIMP-1、TIMP-2、左房内径(LAD)较非HFpEF组更高,患者心肌梗死病史、吸烟比例高于非HFpEF组,补体C1q、LVEF%均低于非HFpEF组,差异均有统计学意义(P<0.05)。Logistic回归分析:NT-proBNP、补体C1q、TIMP-1、左室射血分数百分数(LVEF%)是STEMI患者合并HFpEF的影响因素(P<0.05),NT-proBNP、补体C1q、TIMP-1、LVEF%预测STEMI患者合并HFpE的ROC曲线下面积分别为0.904、0.883、0.793、0.717。结论NT-proBNP、补体C1q、TIMPs和超声心动图参数与STEMI患者是否合并HFpEF有关,各指标预测STEMI患者合并HFpEF有较好的应Objective To investigate the clinical value of serum N-terminal natriuretic peptide precursor(NT-proBNP),complement C1q and tissue metalloproteinase inhibitors(TIMPs)and echocardiography in the prediction of ST elevation myocardial infarction(STEMI)with preserved ejection fraction(HFpEF).Methods A total of 94 STEMI patients admitted to the First Affiliated Hospital of Henan University of Science and Technology from March 2021 to June 2022 were retrospectively selected and divided into HFpEF group(n=38)and non-HFpEF group(n=56)according to the presence of HFpEF.General clinical data[gender,age,body mass index(BMI),systolic BP,diastolic blood pressure,hypertension,diabetes,stroke,medical history of myocardial infarction,smoking,alcohol consumption,white blood cells(WBC),hemoglobin,platelet(PLT),C reactive protein(CRP),blood creatinine,triglycerides,uric acid,high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),blood glucose(FPG)],NT-proBNP,complement C1q and TIMP-1,TI MP-2 levels,echocardiographic parameters were compared between the two groups,and the relationship between NT-proBNP,complement C1q,TIMPs,echocardiographic parameters and whether STEMI patients with HFpEF was analyzed,and the value of each index to predict STEMI patients with HFpEF was analyzed.Results There was no statistically significant difference between the two groups in sex,constitutional index,systolic blood pressure,diastolic blood pressure,hypertension,diabetes,stroke,alcohol consumption,WBC,hemoglobin,PLT,CRP,blood creatinine,triglycerides,uric acid,HDL-C,LDL-C,LV end-diastolic diameter(LVDd),left ventricular end-systolic diameter(LVDs),ventricular septum thickness(IVS),left ventricular posterior wall thickness(LVPW)(P>0.05).Age in HFpEF group,fasting blood FPG,NT-proBNP,TIMP-1,TIMP-2,and left atrial diameter(LAD),history of MI infarction and smoking were higher than those in non-HFpEF group,HFpEF group was lower than that of non-HFpEF group,the differences were statistically significant(P<0.05).Logistic Re

关 键 词：血清N端脑钠肽前体 组织金属蛋白酶抑制剂 超声心动图 ST段抬高型心肌梗死 左室射血分数 

分 类 号：R540.45[医药卫生—心血管疾病] R542.22[医药卫生—内科学]