血清GGT、CysC、ApoB/ApoA1比值与急性ST段抬高型心肌梗死合并2型糖尿病患者预后的关系  

Relationship between Serum GGT,CysC,ApoB/ApoA1 Ratio and Prognosis of Patients with Acute ST Elevation Myocardial Infarction Complicated with Type 2 Diabetes Mellitus

作　　者：李杰[1] 龙燕 陈秋雄[2] 张磊 尹宪华 LI Jie;LONG Yan;CHEN Qiu-xiong;ZHANG Lei;YIN Xian-hua(The Second Clinical Medical College ofGuangzhou University of Traditional Chinese Medicine,Guangzhou,Guangdong,510405,China;Department of Internal Medicine-Cardiovascular,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou,Guangdong,510120,China;Department of Emergency,Chongqing Yongchuan District Traditional Chinese Medicine Hospital,Chongqing,402160,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广东省中医院心血管内科,广东广州510120 [3]重庆市永川区中医院急诊科,重庆402160

出　　处：《现代生物医学进展》2024年第14期2683-2688,共6页Progress in Modern Biomedicine

基　　金：广东省基础与应用基础研究基金项目(2022A1515220191)。

摘　　要：目的:探讨血清γ-谷氨酰转移酶(GGT)、胱抑素C(CysC)、载脂蛋白B/载脂蛋白A1(ApoB/ApoA1)比值与急性ST段抬高型心肌梗死(ASTEMI)合并2型糖尿病(T2DM)患者预后的关系。方法:回顾性收集175例在广东省中医院行经皮冠状动脉介入治疗(PCI)的ASTEMI合并T2DM患者的临床资料,根据PCI术后1个月的预后分为不良预后组(63例)和良好预后组(112例),检测血清GGT、CysC水平和计算ApoB/ApoA1比值。采用多因素Logistic回归分析ASTEMI合并T2DM患者PCI术后不良预后的因素,受试者工作特征曲线(ROC)分析血清GGT、CysC、ApoB/ApoA1比值对ASTEMI合并T2DM患者PCI术后不良预后的预测价值。结果:术后随访1个月,175例ASTEMI合并T2DM患者PCI术后不良预后发生率为36.00%(63/175)。与良好预后组比较,不良预后组血清GGT、CysC、ApoB/ApoA1比值升高(P<0.05)。Killip分级≥Ⅱ级和血清GGT、CysC、ApoB/ApoA1比值升高为ASTEMI合并T2DM患者PCI术后不良预后的独立危险因素(P<0.05)。血清GGT、CysC、ApoB/ApoA1比值联合预测ASTEMI合并T2DM患者PCI术后不良预后的曲线下面积(AUC)为0.924,大于血清GGT、CysC、ApoB/ApoA1比值单独预测的0.776、0.778、0.785。结论:血清GGT、CysC、ApoB/ApoA1比值升高与ASTEMI合并T2DM患者PCI术后不良预后有关,血清GGT、CysC、ApoB/ApoA1比值联合检测对ASTEMI合并T2DM患者PCI术后不良预后具有较高的预测价值。Objective:To investigate the relationship between serumγ-glutamyl transferase(GGT),cystatin C(CysC),apolipoprotein B/apolipoprotein A1(ApoB/ApoA1)ratio and the prognosis of patients with acute ST elevation myocardial infarction(ASTEMI)complicated with type 2 diabetes mellitus(T2DM).Methods:The clinical data of 175 patients with ASTEMI complicated with T2DM who underwent percutaneous coronary intervention(PCI)in Guangdong Provincial Hospital of Traditional Chinese Medicine were retrospectively collected,patients were divided into poor prognosis group(63 cases)and good prognosis group(112 cases)according to the prognosis at 1 month after PCI,Serum GGT and CysC levels were detected and ApoB/ApoA1 ratio was calculated.The factors affecting the poor prognosis of ASTEMI patients complicated with T2DM after PCI were analyzed by multivariate Logistic regression,the predictive value of serum GGT,CysC and ApoB/ApoA1 ratio for the poor prognosis of ASTEMI patients complicated with T2DM after PCI were analyzed by receiver operating characteristic curve(ROC).Results:1 month after follow-up,the incidence of poor prognosis after PCI in 175 ASTEMI patients complicated with T2 DM was 36.00%(63/175).Compared with good prognosis group,the serum GGT,CysC and ApoB/ApoA1 ratio in poor prognosis group increased(P<0.05).Killip grade≥Ⅱ and elevated serum GGT,CysC,ApoB ApoA1 ratio were independent risk factors for poor prognosis in ASTEMI patients complicated with T2 DM after PCI(P<0.05).The area under the curve(AUC)of serum GGT,CysC and ApoB/ApoA1 ratio combined to predict the poor prognosis of ASTEMI patients complicated with T2DM after PCI was 0.924,which was greater than the 0.776,0.778 and 0.785 predicted by serum GGT,CysC and ApoB/ApoA1 ratio alone.Conclusion:Elevated serum GGT,CysC and ApoB/ApoA1 ratio are relate to the poor prognosis of ASTEMI patients complicated with T2DM after PCI,and the combined detection of serum GGT,CysC and ApoB/ApoA1 ratio has a high predictive value for the poor prognosis of ASTEMI patients complica

关 键 词：急性ST段抬高型心肌梗死 2型糖尿病 Γ-谷氨酰转移酶 胱抑素C 载脂蛋白B/载脂蛋白A1比值 预后 

分 类 号：R542.22[医药卫生—心血管疾病]