超声心动图联合sST2、sTREM-1在急性ST段抬高型心肌梗死诊断中的临床价值  

Clinical value of echocardiography combined with serum sST2 and sTREM-1 in the diagnosis of acute ST segment elevation myocardial infarctio

作　　者：苏洁 王书伟[1] 马维东 朱丽[1] 杨静 王书新 曹爱青[3] 高磊 SU Jie;WANG Shuwei;MA Weidong;ZHU Li;YANG Jing;WANG Shuxin;CAO Aiqing;GAO Lei(Department of Ultrasound Diagnosis,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei 061000,China;Department of Cardiology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei 061000,China;Department of Ultrasound,Nanpi County People's Hospital,Cangzhou,Hebei 061500,China;Department of Cardiology,Tangshan Fengnan District Hospital,Tangshan,Hebei 063307,China)

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

出　　处：《检验医学与临床》2024年第17期2492-2496,共5页Laboratory Medicine and Clinic

基　　金：河北省2022年度医学科学研究课题计划项目(20220677)。

摘　　要：目的研究超声心动图指标联合血清可溶性致癌抑制因子2(sST2)、可溶性髓样细胞触发受体-1(sTREM-1)在急性ST段抬高型心肌梗死(STEMI)诊断中的临床价值。方法选取2021年9月至2022年9月在河北省沧州中西医结合医院治疗的90例急性STEMI患者作为STEMI组,选取同期冠状动脉造影检查结果为阴性的90例胸痛患者为对照组,比较两组超声心动图指标左室射血分数(LVEF)、左室舒张末期内径(LVEDD)和血清sST2、sTREM-1水平;采用Pearson相关分析急性STEMI患者LVEF、LVEDD与血清sST2、sTREM-1水平的相关性。采用受试者工作特征(ROC)曲线分析血清sST2、sTREM-1、LVEF、LVEDD诊断急性STEMI的价值。采用多因素Logistic回归分析急性STEMI发生的影响因素。结果STEMI组LVEF低于对照组,LVEDD高于对照组,差异均有统计学意义(P<0.05)。STEMI组CK-MB、cTnI水平及心率、心绞痛史比例高于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,急性STEMI患者LVEF与血清sST2、sTREM-1水平均呈负相关(r=-0.454、-0.463,P<0.05),LVEDD与血清sST2、sTREM-1水平均呈正相关(r=0.493、0.515,P<0.05)。LVEF、LVEDD及血清sST2、sTREM-1联合诊断急性STEMI的曲线下面积(AUC)为0.930,明显大于各项指标单独检测的AUC(Z=4.780、5.611、3.591、3.087,P<0.05)。多因素Logistic回归分析结果显示,sST2≥24.91 ng/mL、sTREM-1≥36.65 pg/mL是急性STEMI发生的危险因素(P<0.05)。结论血清sST2、sTREM-1联合超声心动图对急性STEMI患者的诊断效能较好。Objective To explore the clinical value of echocardiography combined with serum soluble suppression of tumorigenicity 2(sST2)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in the diagnosis of acute ST segment elevation myocardial infarction(STEMI).Methods From September 2021 to September 2022,90 patients with acute STEMI who were treated at Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine were selected as the study group.A total of 90 thoracalgia patients with negative coronary angiography results during the same period were selected as the control group.The left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),serum levels of sST2 and sTREM-1 were compared between the two groups.Pearson correlation analysis was used to investigate the relationship between LVEF,LVEDD and serum sST2,sTREM-1 in patients with acute STEMI.The receiver operating characteristic(ROC)curve was used to analyze the diagnosis of value combined detection of serum sST2,sTREM-1,LVEF and LVEDD in acute STEMI.Multivariate Logistic regression analysis was used to identify the effect factors for acute STEMI.Results The LVEF of the STEMI group was lower than that of the control group,and the LVEDD was higher than that of the control group,with statistically significant differences(P<0.05).The levels of CK-MB,cTnI,heart rate and the proportion of patients with history of angina in the STEMI group were higher than those in the control group,the differences were statistically significant(P<0.05).The Pearson correlation analysis results showed that LVEF correlated negatively with serum sST2 and sTREM-1(r=-0.454,-0.463,P<0.05)in acute STEMI patients.LVEDD correlated positively with serum sST2 and sTREM-1(r=0.493,0.515,P<0.05)in acute STEMI patients.The area under the curve(AUC)of LVEF,LVEDD,serum sST2 and sTREM-1 combined diagnosis of acute STEMI was 0.930,which was greater than that of each indicator detected separately(Z=4.780,5.611,3.591,3.087,P<0.05).The results of multi

关 键 词：可溶性致癌抑制因子2 可溶性髓样细胞触发受体-1 急性ST段抬高型心肌梗死 超声心动图 左室射血分数 左室舒张末期内径 

分 类 号：R446.9[医药卫生—诊断学] R543.1[医药卫生—临床医学]