和肽素、Lp-PLA2、H-FABP及NLR与急性心肌梗死患者心电图缺血分级和预后的关系  

Relationship of copeptin,Lp⁃PLA2,H⁃FABP and NLR with electrocardiogram grading and prognosis in patients with acute myocardial infarction

作　　者：贺睿卿 孙晓冰 于晓卫 HE Ruiqing;SUN Xiaobing;YU Xiaowei(Clinical Laboratory,Shanghai Jiahui International Hospital,ShangHai,China,300020;Emergency Department,Shengli First Hospital in Dongying District,Dongying,Shandong,China,257000)

机构地区：[1]上海嘉会国际医院检验科,上海300020 [2]东营市东营区胜利第一医院,山东东营257000

出　　处：《分子诊断与治疗杂志》2024年第9期1656-1660,共5页Journal of Molecular Diagnostics and Therapy

摘　　要：目的分析研究血清和肽素(COP)、脂蛋白相关磷脂酶A2(Lp-PLA2)、心脏型脂肪酸结合蛋白(H-FABP)及中性粒细胞/淋巴细胞比值(NLR)与急性心肌梗死(AMI)患者心电图缺血分级和预后的关系。方法选取2020年6月至2023年6月上海嘉会国际医院收治的108例AMI患者作为研究对象。根据心电图缺血分级标准,将患者分为二级组(n=62)与三级组(n=46)。比较两组血清COP、Lp-PLA2、H-FABP及NLR水平;采用Spearman相关系数分析AMI患者血清COP、Lp-PLA2、H-FABP、NLR水平与心电图缺血分级的相关性;在常规治疗结束后对患者随访6个月,以随访期间发生主要不良心血管事件或死亡为预后不良,采用单因素、多因素Logistic回归分析AMI患者预后不良的影响因素,并绘制ROC曲线分析血清COP、Lp-PLA2、H-FABP、NLR水平对AMI患者预后不良的预测价值。结果三级组的血清COP、Lp-PLA2、H-FABP、NLR水平均高于二级组,差异均具有统计学意义(均P<0.05);Spearman相关性分析显示,AMI患者血清COP、Lp-PLA2、H-FABP、NLR水平与心电图缺血分级均呈正相关(均P<0.05);多因素Logistic回归分析显示,有糖尿病史(OR=1.902)、心电图缺血分级三级(OR=1.829)、血清COP升高(OR=2.040)、Lp-PLA2升高(OR=1.982)、H-FABP升高(OR=2.073)及NLR水平升高(OR=1.948)均是AMI患者预后不良的独立危险因素(P<0.05);ROC曲线分析显示,血清COP、Lp-PLA2、H-FABP、NLR水平及联合检测的曲线下面积(AUC)分别为0.874、0.890、0.898、0.869、0.989,联合检测优于单一检测(P<0.05)。结论AMI患者血清COP、Lp-PLA2、H-FABP、NLR水平与心电图缺血分级相关,可能成为评估预后的辅助诊断指标。Objective To study the relationship between serum copeptin(COP),lipoprotein-as-sociated phospholipase A2(Lp-PLA2),heart-type fatty acid binding protein(H-FABP),neutrophil/lympho-cyte ratio(NLR),electrocardiogram ischemia classification grade and prognosis in patients with acute myocar-dial infarction(AMI).Methods 108 patients with AMI were admitted to Shanghai Jiahui International Hospi-tal from June 2020 to June 2023 and were retrospectively selected for the study.The patients were divided into gradeⅡgroup(n=62)and gradeⅢgroup(n=46).The serum levels of COP,Lp-PLA2,H-FABP,and NLR were compared between the two groups.Spearman correlation coefficient was used to analyze the correlation between the levels of serum COP,Lp-PLA2,H-FABP,NLR,and ECG ischemia grade in AMI patients.Pa-tients were followed up for 6 months after completing conventional treatment,and major adverse cardiovascu-lar events or death during the follow-up period were considered poor prognosis indicators.Univariate and multi-variate logistic regression analyses were conducted to identify factors influencing poor prognosis in AMI pa-tients.ROC curve analysis was drawn to assess the predictive value of serum COP,Lp-PLA2,H-FABP,and NLR levels in AMI patients with poor prognosis.Results The levels of COP,Lp-PLA2,H-FABP,and NLR in the gradeⅢgroup were higher than those in the grade 2 group,with statistical significance(P<0.05).Spear-man correlation analysis showed that serum levels of COP,Lp-PLA2,H-FABP,and NLR were positively cor-related with ECG ischemia grade in AMI patients(P<0.05).Multivariate logistic regression analysis showed that AMI patients with a history of diabetes(OR=1.902),ECG ischemia grade 3(OR=1.829),elevated serum levels of COP(OR=2.040),Lp-PLA2(OR=1.982),H-FABP(OR=2.073),and NLR(OR=1.948)all had a poor prognosis as independent risk factors(P<0.05).ROC curve analysis showed that the levels of serum COP,Lp-PLA2,H-FABP,and NLR and the area under the curve(AUC)of combined detection were 0.874,0.890,0.898,0.869 and 0.989,respectively

关 键 词：急性心肌梗死 和肽素 脂蛋白相关磷脂酶A2 心脏型脂肪酸结合蛋白 中性粒细胞/淋巴细胞比值 心电图缺血分级 

分 类 号：R542.22[医药卫生—心血管疾病]