超声心动图参数联合血清Adropin、SDC4对急性STEMI患者早期静脉溶栓预后的预测价值  

The predictive value of echocardiography combined with serum Adropin and SDC4 levels for the prognosis of acute STEMI patients after early intravenous thrombolysis

作　　者：苏洁 王书伟 马维东 杨静 朱丽 高磊 曹爱青[4] SU Jie;WANG Shuwei;MA Weidong;YANG Jing;ZHU Li;GAO Lei;CAO Aiqing(Department of Ultrasound Diagnosis,Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou Hebei 061000,China)

机构地区：[1]沧州中西医结合医院超声诊断科,河北沧州061000 [2]沧州中西医结合医院心内科,河北沧州061000 [3]唐山市丰南区医院心内科,河北唐山063307 [4]南皮县人民医院超声科,河北沧州061500

出　　处：《中国急救复苏与灾害医学杂志》2024年第8期993-996,1013,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省2022年度医学科学研究课题计划项目(编号:20220677)。

摘　　要：目的评估超声心动图参数联合血清Adropin、多配体蛋白聚糖4(SDC4)对急性ST段抬高型心肌梗死(STEMI)患者早期静脉溶栓预后的预测价值。方法选取2021年5月—2022年5月河北省沧州中西医结合医院收治的急性STEMI患者136例为STEMI组,同期选择河北省沧州中西医结合医院体检中心进行体检健康的志愿者136例为对照组,超声心动图参数检查左心室射血分数(LVEF)、左房内径(LAD)、左室舒张末期内径(LVEDD)。采用酶联免疫吸附法(ELISA)检测血清Adropin及SDC4水平;受试者工作特征(ROC)曲线法评估超声心动图参数联合血清Adropin及SDC4对急性STEMI患者早期静脉溶栓预后的预测价值。结果STEMI组血清Adropin水平、LVEF显著低于对照组,C-反应蛋白(CRP)、SDC4水平、LAD、LVEDD显著高于对照组(P<0.05)。预后不良组CRP、LAD、LVEDD、SDC4水平显著高于预后良好组,LVEF、Adropin水平显著低于预后良好组(P<0.05)。超声心动图参数联合血清Adropin、SDC4对急性STEMI患者早期静脉溶栓预后预测的AUC显著高于单独预测的AUC(Z=6.721,P=0.010;Z=7.865,P=0.005;Z=6.544,P=0.012;Z=7.345,P<0.001;Z=5.886,P=0.015)。结论急性STEMI患者早期静脉溶栓后血清Adropin呈低表达,SDC4呈高表达,超声心动图参数联合血清Adropin、SDC4对急性STEMI患者早期静脉溶栓预后有较好的预测效能。Objective To evaluate the prognostic value of echocardiographic parameters combined with serum syndecan-4(SDC4)in early intravenous thrombolysis in patients with acute st-elevated myocardial infarction(STEMI).Methods 136 patients with acute STEMI admitted to Cangzhou Hospital of Combined Traditional Chinese and Western Medicine in Hebei Province from May 2021 to May 2022 were selected as the STEMI group,and 136 healthy volunteers who underwent physical examination in the physical examination center of Cangzhou Hospital of Integrated Traditional and Western Medicine of Hebei Province were selected as control group.Left ventricular ejection fraction(LVEF),left atrial diameter(LAD),and left ventricular end-diastolic diameter(LVEDD)were examined by echocardiographic parameters.Serum Adropin and SDC4 levels were detected by enzyme-linked immunosorbent assay(ELISA).Receiver operating characteristics(ROC)curve method was used to evaluate the predictive value of echocardiographic parameters combined with serum Adropin and SDC4 in early intravenous thrombolysis in acute STEMI patients.Results Serum levels of Adropin and LVEF in STEMI group were significantly lower than those in control group,and serum levels of SDC4,LAD and LVEDD were significantly higher than those in control group(P<0.05).Levels of C-reactive protein(CRP),LAD,LVEDD and SDC4 in poor prognosis group were significantly higher than those in good prognosis group.The levels of LVEF and Adropin were significantly lower than those of good prognosis group(P<0.05).The AUC predicted by echocardiographic parameters combined with serum Adropin and SDC4 was significantly higher than that predicted by alone(Z=6.721,P=0.010;Z=7.865,P=0.005;Z=6.544,P=0.012;Z=7.345,P<0.001;Z=5.886,P=0.015).Conclusion Low expression of Adropin and high expression of SDC4 in serum after early intravenous thrombolysis in patients with acute STEMI,echocardiographic parameters combined with serum Adropin and SDC4 have a better predictive efficacy for prognosis of early intravenous thrombolysi

关 键 词：超声心动图参数 Adropin 多配体蛋白聚糖4 急性ST段抬高型心肌梗死 预后 

分 类 号：R542.22[医药卫生—心血管疾病]