超声心动图联合血清肌红蛋白、脑钠肽检测对急性心肌梗死患者PCI术后预后不良的预测价值  

Predictive Value of Echocardiography Parameters Combined with Levels of Serum Myoglobin and Brain Natriuretic Peptide for Poor Prognosis in Patients with Acute Myocardial Infarction After PCI

作　　者：雷媛媛 闫卫 张娜 LEI Yuanyuan;YAN Wei;ZHANG Na(Department of Ultrasound,Zhumadian Central Hospital,Zhumadian 463000,China)

机构地区：[1]驻马店市中心医院超声科,河南驻马店463000

出　　处：《河南医学研究》2024年第20期3742-3745,共4页Henan Medical Research

摘　　要：目的探究超声心动图参数联合血清肌红蛋白(MYO)、脑钠肽(BNP)水平检测对经皮冠状动脉介入术(PCI)后急性心肌梗死患者预后不良的预测价值。方法收集2021年3月至2023年8月于驻马店市中心医院接受PCI治疗的89例急性心肌梗死患者,根据治疗后6个月是否出现不良事件(恶性心律失常、复发、不稳定心绞痛、心力衰竭)可将其分为预后良好、预后不良两组,比较两组一般资料及超声心动图参数、血清水平,采用多因素logistic回归和受试者工作特征(ROC)曲线分析超声心动图参数、血清MYO、BNP水平与急性心肌梗死患者预后不良的关系及预测价值。结果预后良好组病变血管指数≥3支的占比低于预后不良组(P<0.05);预后不良组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室舒张末期容积(LVEDV)、心肌做功指数(Tei)、血清MYO、BNP水平均高于预后良好组,左室收缩末期容积(LVESV)、舒张早期与末期二尖瓣血流峰值速度比值(E/A)低于预后良好组(P<0.05);logistic回归分析显示,LVEDD、LVESD、LVEDV、LVESV、LVEF、E/A、Tei及病变血管支数为出现不良事件的危险因素(P<0.05);各指标单独预测预后不良的曲线下面积(AUC)均>0.6,但联合预测的AUC最高,为0.870(P<0.05)。结论超声心动图参数、血清MYO、BNP水平均为急性心肌梗死患者PCI术后预后不良的危险因素,各指标联合检测可有效提高对急性心肌梗死患者PCI术后预后不良的预测价值。Objective To explore the predictive value of echocardiographic parameters combined with serum myoglobin(MYO)and brain natriuretic peptide(BNP)levels in the prognosis of patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 89 patients with acute myocardial infarction who underwent PCI in Zhumadian Central Hospital from March 2021 to August 2023 were collected.According to whether there were adverse events(malignant arrhythmia,recurrence,unstable angina pectoris,heart failure)six months after treatment,they were divided into good prognosis group and poor prognosis group.The general data,echocardiographic parameters,serum levels of the two groups were compared,multivariate logistic regression and receiver operating characteristic(ROC)curve were used to analyze the relationship and predictive value between echocardiographic parameters,levels of serum MYO,BNP and poor prognosis of patients with acute myocardial infarction.Results The proportion of lesion vascular index≥3 in the good prognosis group was lower than that in the poor prognosis group(P<0.05).The levels of left ventricular end-diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular end diastolic volume(LVEDV),Tei index(Tei),serum MYO and BNP in the poor prognosis group were higher than those in the good prognosis group,while left ventricular end systolic volume(LVESV)and peak velocity ratio of mitral valve blood flow in early and late diastole(E/A)were lower than those in the good prognosis group(P<0.05).Logistic regression analysis showed that LVEDD,LVESD,LVEDV,LVESV,LVEF,E/A,Tei and the number of diseased vessels were the risk factors for adverse events(P<0.05).The area under the curve(AUC)of each index predicting poor prognosis was>0.6,but the AUC of combined prediction was the highest,which was 0.870(P<0.05).Conclusion Echocardiographic parameters,levels of serum MYO and BNP are risk factors for poor prognosis in patients with acute myocardial infarction after PCI.C

关 键 词：经皮冠状动脉介入术 急性心肌梗死 超声心动图 肌红蛋白 脑钠肽 预后不良 预测价值 

分 类 号：R542.22[医药卫生—心血管疾病]