血清H-FABP、GDF-15表达对STEMI患者PCI后不良心血管事件的预测价值  

Predictive Value of Adverse Cardiovascular Events in STEMI Patients after PCI by Serum H-FABP and GDF-15 Expression

作　　者：范存琳[1] FAN Cunlin(Department of Clinical Laboratory,Ganzhou People's Hospital,Ganzhou 341000,China)

机构地区：[1]赣州市人民医院检验科,江西赣州341000

出　　处：《中国医学创新》2024年第18期130-134,共5页Medical Innovation of China

摘　　要：目的:探究血清心型脂肪酸结合蛋白(heart-type fatty acid binding protein,H-FABP)、生长分化因子-15(growth and differentiation factor-15,GDF-15)表达对ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)后不良心血管事件发生的预测价值。方法:采用前瞻性研究,选择2020年6月—2023年6月于赣州市人民医院接受PCI的140例STEMI患者作为研究对象,术前检测患者血清H-FABP、GDF-15,行PCI,术后随访3个月,统计患者术后不良心血管事件发生情况,分析血清H-FABP、GDF-15与STEMI患者术后不良心血管事件发生的关系,同时绘制受试者工作特征(receiver operating characteristic,ROC)曲线,探究血清H-FABP、GDF-15对STEMI患者PCI后不良心血管事件发生的预测价值。结果:随访3个月期间,140例患者均无脱落病例;随访期间,140例STEMI患者PCI后发生不良心血管事件占比为23.57%(33/140),未发生不良心血管事件占比为76.43%(107/140)。两组心肌梗死面积、高血压、既往吸烟史比较,差异均有统计学意义(P<0.05);两组性别、年龄、病变支数、既往饮酒史、肌红蛋白(myoglobin,Myo)、心肌肌钙蛋白I(cardiac troponin I,cTnI)、肌酸激酶同工酶(creatine kinase-MB,CK-MB)、心室舒张末期内径(left ventricular end diastolic dimension,LVEDD)比较,差异均无统计学意义(P>0.05)。发生组血清H-FABP、GDF-15均高于未发生组,差异均有统计学意义(P<0.05)。点二列相关性分析显示,血清H-FABP、GDF-15与STEMI患者PCI后不良心血管事件发生呈正相关(r>0,P<0.05)。ROC曲线结果显示,血清H-FABP、GDF-15单独预测的AUC>0.7,联合预测的AUC>0.8,联合预测价值更高。结论:STEMI患者PCI前血清H-FABP、GDF-15水平越高,术后不良心血管事件发生风险越大,且临床可以将血清H-FABP、GDF-15作为STEMI患者PCI后不良心血管事件发生的有效预测指标。Objective:To investigate the predictive value of serum heart-type fatty acid binding protein(H-FABP)and growth and differentiation factor-15(GDF-15)expression for adverse cardiovascular events in patients with ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Method:A prospective study was conducted,140 STEMI patients who received PCI treatment in Ganzhou People's Hospital from June 2020 to June 2023 were selected as the study subjects.Serum H-FABP and GDF-15 were detected before operation,and PCI was performed.The patients were followed up for 3 months after operation,and the incidence of adverse cardiovascular events was counted.The relationship between serum H-FABP,GDF-15 and postoperative adverse cardiovascular events in STEMI patients was analyzed.At the same time,receiver operating characteristic(ROC)was drawn to explore the predictive value of serum H-FABP and GDF-15 for adverse cardiovascular events in STEMI patients after PCI.Result:During the follow-up period of 3 months,140 patients had no shedding cases.During the follow-up period,among 140 STEMI patients,23.57%(33/140)had adverse cardiovascular events after PCI,and 76.43%(107/140)had no adverse cardiovascular events.There were significant differences in myocardial infarction size,hypertension and smoking history between the two groups(P<0.05).There were no significant differences in gender,age,number of lesions,previous drinking history,myoglobin(Myo),cardiac troponin I(cTnI),creatine kinase-MB(CK-MB),left ventricular end diastolic dimension(LVEDD)between the two groups(P>0.05).Serum H-FABP and GDF-15 in the occurrence group were higher than those in the non-occurrence group,and the differences were statistically significant(P<0.05).Point two-column correlation analysis showed that serum H-FABP and GDF-15 were positively correlated with adverse cardiovascular events after PCI in STEMI patients(r>0,P<0.05).ROC curve results showed that the AUC predicted by serum H-FABP and GDF-15 alone was>0.7,and the AUC p

关 键 词：ST段抬高型心肌梗死 经皮冠状动脉介入治疗 心型脂肪酸结合蛋白 生长分化因子-15 不良心血管事件 

分 类 号：R542.22[医药卫生—心血管疾病]