术前血浆sST2联合AIP对STEMI患者PCI术中发生慢血流/无复流的预测价值  

Predictive value of preoperative plasma sST2 combined with AIP for slow flow/non-reflow during PCI in patients with STEMI

作　　者：郑伟 雷锐[1] 吴宇 ZHENG Wei;LEI Rui;WU Yu(The Third Department of Cardiology,Jiamusi Central Hospital,Jiamusi 154000,China)

机构地区：[1]佳木斯市中心医院心内三科,黑龙江佳木斯154000

出　　处：《山东医药》2023年第31期33-37,共5页Shandong Medical Journal

基　　金：黑龙江省卫生健康委科研课题(2020-368)。

摘　　要：目的探讨术前血浆可溶性生长刺激表达基因2蛋白(sST2)联合血浆动脉粥样硬化指数(AIP)对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术中发生慢血流/无复流(SRF/NRF)的预测价值。方法选取120例STEMI患者为STEMI组,根据PCI术中是否发生SRF/NRF分为分为SRF/NRF组47例、非SRF/NRF组73例;同期另选取57名体检志愿者为对照组。用酶联免疫吸附法检测血浆sST2,全自动生化分析仪检测血浆TG、HDL-C并计算AIP;收集STEMI患者病历资料;用多因素Logistic回归分析STEMI患者PCI术中发生SRF/NRF的影响因素;用受试者工作特征(ROC)曲线分析血浆sST2、AIP对STEMI患者PCI术中发生SRF/NRF的预测价值。结果STEMI组血浆sST2、AIP均高于对照组(P均<0.05)。多因素Logistic回归分析显示,年龄增加、糖尿病和血浆sST2、AIP升高为STEMI患者PCI术中发生SRF/NRF的独立危险因素(P均<0.05)。ROC曲线分析显示,血浆sST2、AIP和二者联合预测STEMI患者PCI术中发生SRF/NRF的曲线下面积分别为0.780、0.777、0.877,二者联合预测的曲线下面积大于单独预测(P均<0.05)。结论术前血浆sST2、AIP升高是STEMI患者PCI术中发生SRF/NRF的危险因素,二者联合对PCI术中发生SRF/NRF的预测价值较高。Objective To investigate the predictive value of preoperative plasma soluble suppression of tumorigenicity 2 protein(sST2)combined with atherogenic index of plasma(AIP)on the development of slow flow/non-reflow(SRF/NRF)during percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Totally 120 STEMI patients were selected as the STEMI group,and they were classified into the SRF/NRF group of 47 cases and the non-SRF/NRF group of 73 cases according to the occurrence of SRF/NRF during PCI;another 57 volunteers for physical examination were selected as the control group during the same period.Plasma sST2 was detected by enzyme-linked immunosorbent assay.Plasma TG and HDL-C were detected,and AIP was calculated by fully automated biochemistry analyzer.The medical records of patients with STEMI were collected.Multifactorial Logistic regression was used to analyze the factors affecting the occurrence of SRF/NRF during PCI in STEMI patients;the predictive value of plasma sST2 and AIP for the occurrence of SRF/NRF during PCI in STEMI patients was analyzed by using the receiver operating characteristic(ROC)curve.Results Plasma sST2 and AIP were higher in the STEMI group than in the control group(both P<0.05).Multifactorial Logistic regression analysis showed that increased age,diabetes mellitus,and elevated plasma sST2 and AIP were independent risk factors for the development of SRF/NRF during PCI in STEMI patients(all P<0.05).ROC curve analysis showed that the area under the curve of plasma sST2,AIP,and the combination of the two in predicting the development of SRF/NRF during PCI in patients with STEMI was 0.780,0.777,and 0.877,respectively,and the area under the curve of the combination of the two with AIP was greater than that of either alone(all P<0.05).Conclusion Elevated preoperative plasma sST2 and AIP are risk factors for the development of SRF/NRF during PCI in STEMI patients,and the combination of the two has a high predictive value for the developmen

关 键 词：急性ST段抬高型心肌梗死 可溶性生长刺激表达基因2蛋白 动脉粥样硬化指数 经皮冠状动脉介入治疗 慢血流 无复流 

分 类 号：R542.2[医药卫生—心血管疾病]