急性前壁ST段抬高型心肌梗死患者血清胸腺肽α1与心功能相关性研究  

Correlation between serum thymosinα1 and cardiac function in patients with acute anterior wall STsegment elevation myocardial infarction

作　　者：周振发 胡翠芬 石冬梅 刘亮[1] 沈成兴 ZHOU Zhenfa;HU Cuifen;SHI Dongmei;LIU Liang;SHEN Chengxing(Department of Cardiology,Affiliated Shanghai Sixth People's Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第六人民医院心内科,200233 [2]复旦大学附属闵行医院超声科

出　　处：《介入放射学杂志》2024年第7期717-722,共6页Journal of Interventional Radiology

基　　金：上海申康医院发展中心重大临床研究项目(SHDC2020CR1042)。

摘　　要：目的 探讨急性前壁ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后住院期间血清胸腺肽(Tα1)水平与左心室射血分数(LVEF)的相关性。方法 纳入2019年12月至2022年2月在上海市第六人民医院诊治的急性前壁STEMI患者74例(急性前壁STEMI组),无心肌梗死患者38例(对照组)。根据PCI开通前降支后住院期间LVEF值,将急性前壁STEMI患者分为LVEF<50%组(33例)和LVEF≥50%组(41例)。采用酶联免疫吸附试验(ELISA)法测定患者血清Tα1水平并进行组间比较。采用logistic回归分析Tα1水平与LVEF相关性。绘制急性前壁STEMI患者PCI后Tα1水平对心功能预测价值的受试者工作特征曲线(ROC)。结果 急性前壁STEMI LVEF≥50%组患者血清Tα1水平显著高于LVEF<50%组(P=0.032)。PCI后住院期间血清Tα1与LVEF呈正相关。logistic回归分析表明,Tα1水平是PCI后急性前壁STEMI患者LVEF<50%的独立预测因素。血清Tα1水平预测急性前壁STEMI患者住院期间LVEF≥50%ROC曲线下面积为0.644(P=0.034);联合肌钙蛋白Ⅰ峰值、NT-proBNP峰值预测急性前壁STEMI患者住院期间LVEF<50%ROC曲线下面积分别为0.780(P<0.01)、0.702(P=0.003)。以急性前壁STEMI患者血清Tα1水平中位数为界,PCI后血清Tα1水平>2 890 ng/L患者LVEF≥50%比例较高。结论 急性前壁STEMI患者血清Tα1水平与PCI后住院期间LVEF值密切相关,是急性前壁STEMI患者PCI后心功能改善的独立预测因素,有望成为开通罪犯血管后预测急性前壁STEMI心功能改善的新指标。Objective To explore the correlation between serum thymosinα1 level and left ventricular ejection fraction(LVEF)in patients with acute anterior wall ST-segment elevation myocardial infarction(STEMI)after receiving percutaneous coronary intervention(PCI).Methods A total of 74 patients with acute anterior wall STEMI(acute anterior wall STEMI group)and 38 patients having no myocardial infarction(control group),who were admitted to the Shanghai Sixth People's Hospital of China from December 2019 to February 2022,were enrolled in this study.According to the LVEF value after the recanalization of anterior descending coronary artery with PCI during hospitalization period,the patients of acute anterior wall STEMI group were divided into LVEF<50%subgroup(n=33)and LVEF≥50%subgroup(n=41).Serum thymosinα1 level was determined by enzyme linked immunosorbent assay(ELISA),the results were compared between the groups.Logistic regression analysis was used to analyze the correlation between thymosinα1 level and LVEF.The receiver operating characteristic(ROC)curve of serum thymosinα1 level for predicting cardiac function in patients with acute anterior wall STEMI after receiving PCI was drawn.Results The serum thymosinα1 level in LVEF≥50%subgroup was significantly higher than that in the LVEF<50%subgroup(P=0.032).During the post-PCI hospitalization period,the serum thymosinα1 level was positively correlated with LVEF.Logistic regression analysis revealed that serum thymosinα1 level was an independent predictor for LVEF<50%in patients with acute anterior wall STEMI after receiving PCI.The area under ROC of serum thymosinα1 level for predicting LVEF≥50%in patients with acute anterior wall STEMI during hospitalization was 0.644(P=0.034).The area under ROC of serum thymosinα1 level combined with peak troponin I level and with peak NT-proBNP level for predicting LVEF<50%in patients with acute anterior wall STEMI during hospitalization was 0.780(P<0.01)and 0.702(P=0.003)respectively.When taking the median serum thymosinα1

关 键 词：急性前壁ST段抬高型心肌梗死 胸腺肽Α1 左心室射血分数 

分 类 号：R542.22[医药卫生—心血管疾病]