急性心肌梗死患者血清sTNFR1、CD137水平变化对MACE的影响及发生MACE的影响因素分析  

Analysis of the impact of changes in serum levels of sTNFR1 and CD137 on MACE in patients with acute myocardial infarction and the influencing factors of MACE occurrence

作　　者：李艳萍 李建成 孙春喜[1] LI Yan-ping;LI Jian-cheng;SUN Chun-xi(Department of Cardiovascular Medicine,Shangluo Central Hospital,Shangluo Shaanxi 726000,China)

机构地区：[1]商洛市中心医院心血管内科,陕西商洛726000

出　　处：《临床和实验医学杂志》2024年第15期1583-1587,共5页Journal of Clinical and Experimental Medicine

基　　金：陕西省自然科学基础研究计划项目(编号:2020JM-665)。

摘　　要：目的探讨急性心肌梗死(AMI)患者血清可溶性肿瘤坏死因子受体1(sTNFR1)、白细胞分化抗原-137(CD137)水平变化对心血管不良事件(MACE)的影响及发生MACE的影响因素。方法前瞻性选取2019年10月至2022年3月商洛市中心医院收治的AMI患者120例作为观察组,并根据AMI患者MACE发生情况分为MACE组(n=25)及非MACE组(n=95),另选取同期来我院体检的健康者120名作为对照组。收集AMI患者一般资料与临床特征:性别、年龄、体重指数、合并糖尿病、高脂血症、高血压、Killip心功能分级、饮酒史、吸烟史、左心室射血分数、预后危险[心肌梗死溶栓(TIMI)评分]、脑钠肽、肌钙蛋白T水平。比较观察组与对照组、MACE组与非MACE组的血清sTNFR1、CD137水平。采用Pearson相关性分析法分析sTNFR1、CD137与AMI后MACE发生的相关性。采用单因素分析和多因素Logistics回归分析对影响AMI后MACE的因素进行分析。结果观察组sTNFR1、CD137水平分别为(372.53±65.26)μg/L、(125.75±23.67)pg/mL,均高于对照组[(231.56±46.80)μg/L、(71.43±11.57)pg/mL],差异均有统计学意义(P<0.05)。MACE组sTNFR1、CD137水平分别为(398.64±45.73)μg/L、(154.56±23.57)pg/mL,均高于非MACE组[(347.83±61.72)μg/L、(106.84±20.65)pg/mL],差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,sTNFR1、CD137与AMI后MACE发生情况呈正相关(P<0.05)。非MACE组与MACE组患者性别、体重指数、饮酒史、左心室射血分数比较,差异均无统计学意义(P>0.05),非MACE组与MACE组患者年龄、合并糖尿病、高脂血症、高血压、Killip心功能分级、吸烟史、TIMI评分、脑钠肽、肌钙蛋白T水平比较,差异均有统计学意义(P<0.05)。以合并MACE为因变量,结果显示,心功能分级、吸烟史、TIMI、脑钠肽、sTNFR1、CD137为AMI后MACE的独立危险因素(P<0.05)。结论AMI患者MACE发生后会导致sTNFR1、CD137水平升高,且心功能分级、吸烟史、TIMI评分、脑Objective To investigate the effects of changes in serum soluble tumor necrosis factor receptor 1(sTNFR1)and leukocyte differentiation antigen-137(CD137)levels on MACE and the influencing factors of MACE in patients with acute myocardial infarction(AMI).Methods One hundred and twenty AMI patients admitted to Shangluo Central Hospital from October 2019 to March 2022 were prospectively selected as the observation group.According to the incidence of major adverse cardiovascular events(MACE)in AMI patients,they were divided into the MACE group(n=25)and non MACE group(n=95).In addition,120 healthy individuals who underwent physical examinations during the same period in our hospital were selected as the control group.The general data and clinical characteristics of AMI patients were collected:gender,age,body mass index,diabetes mellitus,hyperlipidemia,hypertension,Killip cardiac function classification,drinking history,smoking history,left ventricular ejection fraction,prognostic risk[thrombolysis in myocardial infarction(TIMI)score],brain natriuretic peptide,troponin T level.The levels of serum sTNFR1 and CD137 in the observation group and the control group,on-MACE group and MACE group were compared.The correlation between sTNFR1,CD137 and MACE after AMI was analyzed using Pearson correlation analysis.The factors affecting MACE after AMI were analyzed by univariate analysis and multivariate Logistics regression analysis.Results The levels of sTNFR1 and CD137 in the observation group were(372.53±65.26)μg/L,(125.75±23.67)pg/mL,which were higher than those in the matched group[(231.56±46.80)μg/L,(71.43±11.57)pg/mL],the differences were statistically significant(P<0.05);the levels of sTNFR1 and CD137 in the MACE group were(398.64±45.73)μg/L and(154.56±23.57)pg/mL,respectively,which were higher than those in the non MACE group[(347.83±61.72)μg/L,(106.84±20.65)pg/mL],the differences were statistically significant(P<0.05).The Pearson correlation analysis results showed that sTNFR1 and CD137 were positively corre

关 键 词：心肌梗死 不良心血管事件 可溶性肿瘤坏死因子受体1 白细胞分化抗原-137 

分 类 号：R542.22[医药卫生—心血管疾病]