STEMI急诊PCI术后炎症、心功能改变与MACE的相关研究  

The correlation between inflammation,cardiac function changes and MACE after STEMI emergency PCI surgery

作　　者：吕帅 高翔[1] 金泽桦 吕坤 丁进龙 LV Shuai;GAO Xiang;JIN Zehua(People's Hospital of Xinchang County,Zhejiang 312500,China)

机构地区：[1]浙江省新昌县人民医院,新昌312500 [2]杭州艾迪康医学检验中心

出　　处：《浙江创伤外科》2023年第10期1826-1829,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的 探究急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入(PCI)术后髓过氧化物酶(MPO)、心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)、高敏C反应蛋白(hs-CRP)水平变化及其与主要不良心脏事件(MACE)发生的相关性。方法 回顾性分析本院在2019年2月至2022年6月收治的324例行急诊PCI术治疗的STEMI患者的临床资料,根据是否发生MACE分为两组,发生的为观察组132例,未发生的为对照组192例。比较两组术前、术后1 h、3 d后MPO、cTnT、CK-MB、hs-CRP水平变化;Logisitic回归分析STEMI患者急诊PCI术后发生MACE的影响因素,绘制受试者工作特征(ROC)曲线评估各指标的预测价值。结果 术后1 h,两组MPO、cTnT、CK-MB及hs-CRP较术前均显著升高,术后第3 d两组均逐渐降低,对照组在术后3 d各指标逐渐恢复到正常参考水平范围内(P<0.05),且观察组术前、术后1 h、术后3 d各指标均高于对照组,组间比较差异具有统计学意义(P<0.05)。经Spearman相关分析,MPO、cTnT、CK-MB、hs-CRP及多指标联合检测结果与STEMI患者发生MACE均存在正相关关系,且MPO+hs-cTnT+CK-MB+hs-CRP指标联合相关性最高(r=0.859,P<0.05)。Logistic回归分析,MPO、cTnT、CK-MB及hs-CRP是STEMI患者发生MACE的影响因素。经ROC曲线分析,MPO、cTnT、CK-MB及hs-CRP的AUC分别为0.879、0.668、0.649、0.679,多指标联合诊断具有更高的鉴别效能。结论 MPO、cTnT、CK-MB以及hs-CRP水平与STEMI患者PCI预后发生MACE密切相关,联合检测具有更好的诊断效能。Objective To investigate the changes in levels of myeloperoxidase(MPO),cardiac troponin T(cTnT),creatine kinase isoenzyme(CK-MB),and high sensitivity C-reactive protein(hs-CRP) in patients with acute ST segment elevation myocardial infarction(STEMI) after emergency percutaneous coronary intervention(PCI),and their correlation with the occurrence of major adverse cardiac events(MACE).Methods A retrospective analysis was conducted on the clinical data of 324 STEMI patients treated with emergency PCI in our hospital from February 2019 to June 2022.They were divided into two groups based on the occurrence of MACE,with 132 cases in the observation group and 192 cases in the control group.The changes in MPO,cTnT,CK-MB,and hs-CRP levels before,1 hour,and 3 days after surgery between the two groups were compared.Logistic regres-sion analysis was conducted on the influencing factors of MACE in STEMI patients after emergency PCI,and the predictive value of each indicator was evaluated by plotting the subject work characteristic(ROC) curve.Results At 1 hour after surgery,MPO,cTnT,CK-MB,and hs-CRP in both groups significantly increased compared to before surgery,at 3 days after surgery,both groups gradually decreased,the control group gradually recov-ered to the normal reference level range at 3 days after surgery(P<0.05),and the observation group had higher levels of MPO,cTnT,CK-MB,and hsCRP than the control group,the difference between the groups was statistically significant( P<0.05).According to Spearman correlation analysis,MPO,cTnT,CK-MB,hs-CRP,and the combined detection results of multiple indicators had a positive correlation with the occurrence of MACE in STEMI patients,and the combined correlation of MPO+hs cTnT+CK-MB+hs-CRP indicators were the highest( r=0.859,P<0.05).Logistic regression analysis showed that MPO,c TnT,CK-MB,and hs-CRP were influencing factors for the occurrence of MACE in STEMI patients.After ROC curve analysis,the AUC of MPO,cTnT,CK-MB,and hs-CRP were 0.879,0.668,0.649,and 0.679,the combined diag

关 键 词：急性ST心肌梗死 PCI 指标变化 不良心血管事件 

分 类 号：R654.2[医药卫生—外科学]