血清H-FABP、GDF-15、sICAM-1与PCI后心肌损伤的关系分析  

Relationship between serum H-FABP,GDF-15,sICAM-1 and myocardial injury after percutaneous coronary intervention

作　　者：徐艺[1] 王均生[1] 考国营 李均[1] XU Yi;WANG Jun-sheng;KAO Guo-ying;LI Jun(Department of Cardiovascular Medicine,Chongqing Emergency Medical Center/Chongqing Fourth People's Hospital,Chongqing 400014,China)

机构地区：[1]重庆市急救医疗中心/重庆市第四人民医院心血管内科,重庆400014

出　　处：《局解手术学杂志》2023年第10期898-901,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆市自然科学基金面上项目(cstc2021jcyj-msxmX1061);重庆市体育局科研项目(C202201)。

摘　　要：目的分析冠心病相关血清指标心型脂肪酸结合蛋白(H-FABP)、生长分化因子15(GDF-15)、可溶性细胞间黏附分子-1(sICAM-1)与经皮冠状动脉介入术(PCI)后心肌损伤的关系。方法回顾性选取2020年3月至2022年3月在本院接受PCI治疗的200例冠心病患者为研究对象,根据术后3个月是否出现心肌损伤,将其分为心肌损伤组(n=42)和心肌未损伤组(n=158)。比较2组各项临床资料及血清H-FABP、GDF-15、sICAM-1等实验室指标水平,并采用受试者工作特征(ROC)曲线分析以上指标与冠心病患者PCI后心肌损伤的关系。结果心肌损伤组患者从发病到治疗时间明显长于心肌未损伤组,血清H-FABP、GDF-15、sICAM-1水平均高于心肌未损伤组(P<0.05)。建立相关性模型,结果显示,PCI后心肌受损与从发病到治疗时间相关性较弱(r=0.168,P<0.05),与血清H-FABP、GDF-15、sICAM-1均存在中等程度相关(r=0.424、0.403、0.442,P<0.05)。ROC曲线模型显示,血清H-FABP、GDF-15、sICAM-1均对PCI后心肌损伤具有一般诊断效能,三项联合检测具有较高准确性,其诊断AUC、约登指数、灵敏度、特异性分别为0.912、0.585、95.24%、63.29%。结论血清H-FABP、GDF-15、sICAM-1与冠心病患者PCI后心肌损伤的发生密切相关,三项血液指标联合检测对心肌损伤具有较高诊断和预测价值。Objective To analyze the relationship between the serum indexes related to coronary heart disease of heart-type fatty acid-binding protein(H-FABP),growth differentiation factor 15(GDF-15),soluble intercellular adhesion molecule-1(sICAM-1)and myocardial injury after percutaneous coronary intervention(PCI).Methods A total of 200 patients with coronary heart disease who received PCI in our hospital from March 2020 to March 2022 were retrospectively selected as the study subjects.According to whether myocardial injury occurred 3 months after operation,they were divided into the myocardial injury group(n=42)and the myocardial uninjuried group(n=158).The clinical data and the serum levels of H-FABP,GDF-15 and sICAM-1 were compared between the two groups,and the relationship between the above indexes and myocardial injury after PCI was analyzed by receiver operating characteristic(ROC)curve.Results The time from onset to treatment in the myocardial injury group was significantly longer than that in the myocardial uninjuried group,and the serum levels of H-FABP,GDF-15 and sICAM-1 were higher than those in the myocardial uninjuried group(P<0.05).The correlation model was established and the results showed that the myocardial injury after PCI was weakly correlated with the time from onset to treatment(r=0.168,P<0.05),and moderately correlated with serum H-FABP,GDF-15 and sICAM-1(r=0.424,0.403,0.442,P<0.05).ROC curve model showed that the serum H-FABP,GDF-15 and sICAM-1 all had general diagnostic efficacy for myocardial injury after PCI,and the three combined tests had higher accuracy,with diagnostic AUC,Youden index,sensitivity and specificity of 0.912,0.585,95.24%and 63.29%,respectively.Conclusion Serum H-FABP,GDF-15 and sICAM-1 are closely related to the myocardial injury of patients with coro⁃nary heart disease after PCI.The combined detection of these three blood indexes has high diagnostic and predictive value for myocardial injury.

关 键 词：心型脂肪酸结合蛋白 生长分化因子15 可溶性细胞间黏附分子-1 心肌损伤 

分 类 号：R446.1[医药卫生—诊断学]