AMI患者PCI术后血清PAF、CK-MB、sCD40L水平变化及其与再缺血的关系  

Changes in serum PAF,CK-MB,and sCD40L levels after percutaneous coronary intervention in patients with acute myocardial infarction and their relationship with recurrent ischemia

作　　者：韩艳平[1] 张慧慧[1] 菅广敏 刘红春[1] 龙美静 HAN Yan-ping;ZHANG Hui-hui;JIAN Guang-min;LIU Hong-chun;LONG Mei-jing(Department of Clinical Laboratory,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院检验科,河南郑州450000

出　　处：《海南医学》2024年第9期1287-1292,共6页Hainan Medical Journal

基　　金：2020年河南省自然科学基金(编号:202300410464)。

摘　　要：目的探究急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后血清血小板活化因子(PAF)、肌酸激酶同工酶(CK-MB)、可溶性白细胞分化抗原40配体(sCD40L)水平的变化,并分析其与术后再缺血的关系。方法前瞻性选取2019年10月至2022年10月郑州大学第一附属医院收治的225例AMI患者作为研究对象,检测围手术期(术前、术后3 d、术后14 d)所有患者的血清PAF、CK-MB、sCD40L水平,术后接受为期1年随访,根据PCI术后有无再缺血发生分为再缺血发生组30例和再缺血未发生组195例。比较两组患者的临床资料及血清PAF、CK-MB、sCD40L水平;采用Logistic回归方程分析AMI患者PCI术后再缺血影响因素;绘制受试者工作特征曲线(ROC)分析血清PAF、CK-MB、sCD40L水平对AMI患者PCI术后再缺血的预测价值。结果再缺血发生组患者的中国冠心病患者抗血小板治疗优选方案(OPT-CAD)评分为(102.41±15.83)分,明显高于再缺血未发生组的(82.37±10.69)分,差异有统计学意义(P<0.05);再缺血发生组患者术后3 d、14 d的血清PAF水平分别为(89.15±20.11)ng/mL、(78.60±13.24)ng/mL,明显高于再缺血未发生组的(79.85±17.69)ng/mL、(67.42±10.38)ng/mL,CK-MB水平分别为(38.28±11.94)μg/L、(23.09±6.83)μg/L,明显高于再缺血未发生组的(34.83±10.16)μg/L、(17.69±5.12)μg/L,sCD40L水平分别为(4681.69±305.63)pg/mL、(3721.59±175.63)pg/mL,明显高于再缺血未发生组的(4369.39±227.84)pg/mL、(3129.46±132.88)pg/mL,差异均有统计学意义(P<0.05);经Logistic回归方程分析结果显示,OPT-CAD评分及术后3 d、14 d血清PAF、CK-MB、sCD40L水平均为AMI患者PCI术后再缺血发生的危险因素(P<0.05);经ROC分析结果显示,术后3 d血清PAF、CK-MB、sCD40L联合预测再缺血发生的AUC为0.877,术后14 d血清PAF、CK-MB、sCD40L联合预测再缺血发生的AUC为0.930,均大于各时间点三项血清指标单独预测。结论血清PAF、CK-MB、sCD40L水平是AMI患者PCI术后再缺Objective To investigate the changes of serum platelet activating factor(PAF),creatine kinase isoenzyme(CK-MB),and Soluble Cluster of differentiation 40 ligand(sCD40L)levels in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI),and to analyze the relationship between them and recurrent ischemia after surgery.Methods A prospective study was conducted on 225 patients with AMI admitted to the First Affiliated Hospital of Zhengzhou University from October 2019 to October 2022.The levels of serum PAF,CK-MB,and sCD40L were measured in all patients during the perioperative period(preoperative,postoperative 3 days,and postoperative 14 days).After surgery,all patients were followed up for 1 year.The patients were divided into two groups according to the recurrent ischemia after PCI:30 patients with recurrent ischemia and 195 patients without recurrent ischemia.Clinical data and serum PAF,CK-MB,and sCD40L levels were compared between the two groups of patients.Logistic regression equations were used to analyze the factors affecting recurrence of ischemia in AMI patients after PCI.Receiver operating characteristic(ROC)curves were drawn to analyze the predictive value of serum PAF,CK-MB,and sCD40L levels for recurrence of ischemia in AMI patients after PCI.Results The score of the Optimal Antiplatelet Therapy for Chinese patients with Coronary Artery Disease(OPT-CAD)in patients with recurrent ischemia was(102.41±15.83)points,which was significantly higher than(82.37±10.69)points in patients without recurrent ischemia(P<0.05).The serum PAF levels in patients with recurrent ischemia were(89.15±20.11)ng/mL and(78.60±13.24)ng/mL on postoperative day 3 and day 14,respectively,which were significantly higher than(79.85±17.69)ng/mL and(67.42±10.38)ng/mL in patients without recurrent ischemia;the CK-MB levels were(38.28±11.94)μg/L and(23.09±6.83)μg/L on postoperative day 3 and day 14,respectively,which were significantly higher than(34.83±10.16)μg/L and(17.69±5.12)μg/L in patien

关 键 词：急性心肌梗死 经皮冠状动脉介入术 再缺血事件 血小板活化因子 肌酸激酶同工酶 可溶性白细胞分化抗原40配体 

分 类 号：R542.22[医药卫生—心血管疾病]