急性心肌梗死患者血清TSP-1、Cat S、Visfatin与PCI术后心肌微循环障碍的关系及其预后价值  

Relationship between serum TSP-1,Cat S,Visfatin and myocardial microcirculation disorders in patients with acute myocardial infarction after PCI and their prognostic value

作　　者：宋宝珠[1] 张迪华 常小铁 齐娜娜 张超红[1] SONG Baozhu;ZHANG Dihua;CHANG Xiaotie;QI Nana;ZHANG Chaohong(Department of Critical Care Medicine,Yellow River Sanmenxia Hospital,Sanmenxia,Henan 472000,China)

机构地区：[1]黄河三门峡医院重症医学科,河南三门峡472000

出　　处：《国际检验医学杂志》2024年第21期2626-2631,共6页International Journal of Laboratory Medicine

基　　金：中国水利水电第十一工程局有限公司科技项目(2021-217)。

摘　　要：目的探讨急性心肌梗死(AMI)患者血清血小板反应蛋白-1(TSP-1)、组织蛋白酶s(Cat S)、内脂素(Visfatin)与经皮冠状动脉介入治疗(PCI)术后心肌微循环障碍的关系及其在临床预后中的价值。方法选择2021年6月至2023年6月在该院进行PCI治疗的AMI患者90例,按照心肌微循环状态分为微循环障碍组(62例)和正常组(28例),按照患者术后的预后情况分为预后良好组(50例)和预后不良组(40例)。Logistic回归分析预后不良的危险因素,受试者工作特征(ROC)曲线分析血清TSP-1、Cat S、Visfatin的预测价值。结果微循环障碍组血清TSP-1、Cat S、Visfatin水平高于正常组,预后不良组高于预后良好组,差异均有统计学意义(P<0.05);血清TSP-1、Cat S、Visfatin水平升高是AMI行PCI术后患者预后不良的危险因素(P<0.05);血清TSP-1、Cat S、Visfatin水平联合预测AMI行PCI术后患者预后状况的效能高于各指标单独预测(Z联合-TSP-1=2.245,P=0.025;Z_(联合-Cat) S=2.101,P=0.036;Z_(联合-Visfatin)=2.252,P=0.024)。结论AMI行PCI术后心肌微循环障碍患者血清TSP-1、Cat S、Visfatin水平显著上升,且三者联合预测AMI患者PCI术后预后的效能较高。Objective To explore the relationship between serum thrombospondin-1(TSP-1),cathepsin S(Cat S),and Visfatin in patients with acute myocardial infarction(AMI)and myocardial microcirculation disorders after PCI and their clinical prognostic value.Methods A total of 90 AMI patients who underwent PCI treatment in the hospital from June 2021 to June 2023 were enrolled in the study.They were grouped into a microcirculation disorder group(62 cases)and a normal group(28 cases)based on their myocardial microcirculation status.According to their postoperative prognosis,they were grouped into a good prognosis group(50 cases)and a poor prognosis group(40 cases).The risk factors of poor prognosis were analyzed by Logistic regression,and the predictive value of serum TSP-1,Cat S and Visfatin was analyzed by receiver operating characteristic(ROC)curve.Results The serum levels of TSP-1,Cat S,and Visfatin in the microcirculation disorders group were higher than those in the normal group,and those in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).Elevated levels of serum TSP-1,Cat S,and Visfatin were risk factors for poor prognosis in AMI patients after PCI(P<0.05).The efficacy of combined detection of serum TSP-1,Cat S,and Visfatin levels for predicting the prognosis of AMI patients after PCI was higher than that of single detection(Z_(combined prediction-TSP-1)=2.245,P=0.025,Z_(combined prediction-Cat )S=2.101,P=0.036,Z_(combined prediction-Visfatin)=2.252,P=0.024).Conclusion The serum levels of TSP-1,Cat S and Visfatin are obviously increased in AMI patients with myocardial microcirculation disorders after PCI,and the combination of the three has relatively high efficacy in predicting the prognosis of AMI patients after PCI.

关 键 词：急性心肌梗死 血小板反应蛋白-1 组织蛋白酶S 内脂素 经皮冠状动脉介入治疗 心肌微循环障碍 预后 

分 类 号：R542.22[医药卫生—心血管疾病]