急性心肌梗死患者血清sCAM-1、S100A4及脂代谢变化与MACE发生的关系  

Serum sCAM-1,S100A4,and lipid metabolism changes in patients with acute myocardial infarction in relation to MACE occurrence

作　　者：时磊 杨好远 SHI Lei;YANG Haoyuan(Department of Emergency Medicine,Xuchang Central Hospital,Xuchang 461000,Henan,China)

机构地区：[1]许昌市中心医院急诊科,河南许昌461000

出　　处：《中国校医》2024年第5期369-372,共4页Chinese Journal of School Doctor

摘　　要：目的分析血清可溶性细胞间黏附分子-1(sCAM-1)、血清钙卫蛋白A4(S100A4)及脂代谢水平预测急性心肌梗死患者发生主要心血管不良事件(MACE)的价值。方法回顾性分析本院2020年12月—2022年11月收治的98例急性心肌梗死患者的临床资料,根据其治疗期间及出院后6个月内是否发生MACE分为良好组(71例未发生)和不良组(27例发生)。所有患者入院时检测血清sCAM-1、S100A4及血脂[总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)],并进行2组比较,使用受试者工作曲线(ROC)分析以上指标联合预测急性心肌梗死患者治疗期间及出院后6个月内发生MACE的价值。结果不良组血清sCAM-1、S100A4及TC、LDL-C、HDL-C水平分别为(329.38±33.86)μg/L、(99.15±11.22)pg/mL、(4.92±1.15)mmol/L、(2.62±0.48)mmol/L、(1.06±0.27)mmol/L,良好组分别为(303.70±36.64)μg/L、(86.23±8.76)pg/mL、(3.92±0.89)mmol/L、(2.36±0.52)mmol/L、(1.28±0.35)mmol/L,差异均有统计学意义(t=3.163、6.022、4.572、2.257、2.946,P均<0.05)。ROC曲线分析结果显示:血清sCAM-1、S100A4及TC、HDL-C、LDL-C水平联合预测急性心肌梗死患者治疗期间及出院后6个月内发生MACE的曲线下面积(AUC)为0.919,敏感度为96.30%,特异度为59.15%。结论血清sCAM-1、S100A4及血脂变化联合预测急性心肌梗死患者治疗期间及出院后6个月内发生MACE具有较高价值,可为临床诊治提供客观参考依据。Objective This study analyzed the value of serum soluble cell adhesion molecule-1(sCAM-1),serum calreticulin A4(S100A4),and lipid metabolism in predicting the occurrence of major adverse cardiovascular events(MACE)in patients with emergency myocardial infarction.Methods Clinical data for 98 patients with acute myocardial infarction admitted to our hospital between December 2020 and November 2022 were retrospectively analyzed.Patients were classified into good(n=71,no MACE)and poor(n=27,MACE)groups according to MACE occurrence during the treatment period and 6 months after discharge.Serum sCAM-1,S100A4,and lipid metabolism were measured in all patients at the time of admission to the hospital and compared between groups.The combined value of the above indicators in predicting MACE occurrence during treatment and 6 months after discharge was examined through ROC analysis.Results The serum sCAM-1,S100A4,TC,LDL-C,and HDL-C levels in patients with acute myocardial infarction in the poor group were 329.38±33.86μg/L,99.15±11.22 pg/mL,4.92±1.15 mmol/L,2.62±0.48 mmol/L,and 1.06±0.27 mmol/L,respectively,whereas those in the good group were 303.70±36.64μg/L,86.23±8.76 pg/mL,3.92±0.89 mmol/L,2.36±0.52 mmol/L,and 1.28±0.35 mmol/L;the differences were statistically significant(t=3.163,6.022,4.572,2.257,2.946;all P<0.05).ROC analysis of the value of the combination of serum sCAM-1,S100A4,and TC,HDL-C,and LDL-C in predicting the risk of MACE occurrence during treatment and 6 months after discharge indicated an area under the curve(AUC)of 0.919,with a sensitivity of 96.30%and a specificity of 59.15%.Conclusion The combination of serum sCAM-1,S100A4,and lipid metabolism changes in patients with acute myocardial infarction has a high value in predicting MACE occurrence during the treatment period and 6months after hospital discharge,thus providing anObjective reference for clinical diagnosis and treatment.

关 键 词：心肌梗死 主要心血管不良事件 血脂障碍 细胞间黏附分子-1 

分 类 号：R446[医药卫生—诊断学]