SYNTAX积分联合血清NT-pro BNP、CK-MB、cTnI水平对急性心肌梗死患者PCI术预后的评估价值  

Value of SYNTAX score combined with serum NT-pro BNP,CK-MB and cTnI levels on evaluating the prognosis of AMI undergoing coronary intervention

作　　者：付春生 张浩[1] 周姝[1] 张庆龙[1] 李雪翔[1] FU Chunsheng;ZHANG Hao;ZHOU Shu;ZHANG Qinglong;LI Xuexiang(Department of Emergency Medicine,The Second Affiliated Hospital of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学第二附属医院急诊内科,安徽合肥230000

出　　处：《西部医学》2024年第11期1643-1647,共5页Medical Journal of West China

基　　金：2021年度安徽省卫生健康委科研项目(AHWJ2021a017)。

摘　　要：目的探讨SYNTAX积分联合血清N末端钠尿肽前体(NT-pro BNP)、肌酸激酶同工酶(CK-MB)、心肌钙蛋白(cTnI)水平评估急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术预后的价值。方法选取2020年1月—2022年11月我院85例行PCI术的AMI患者为研究对象,根据患者术后是否存在主要不良心脑血管事件(MACCE)分为预后良好组(n=63)和预后不良组(n=22),术前均行冠脉造影,采用SYNTAX积分评估患者冠脉变程度,住院期间常规测定患者血清NT-pro BNP、CK-MB、cTnI水平,术后随访半年。比较两组一般临床资料、SYNTAX积分及血清NT-pro BNP、CK-MB、cTnI水平,采用多因素Logistic回归分析法分析影响AMI患者PCI术预后的危险因素,采用受试者工作曲线分析SYNTAX积分联合血清NT-pro BNP、CK-MB、cTnI水平对AMI患者PCI术预后的评估价值。结果两组性别、年龄、BMI、合并高血压、糖尿病、血清TC、TG、HDL-C、LDL-C、Scr、LVEF、LVEDD比较,差异无统计学意义(P>0.05),Killip分级、病变支数分布、支架置入数、介入治疗时间、住院时间比较,差异均有统计学意义(P<0.05);预后不良组SYNTAX积分、血清NT-pro BNP、CK-MB、cTnI水平均显著高于预后良好组(P<0.05);多因素Logistic回归分析显示,病变支数、支架置入数、SYNTAX积分、血清NT-pro BNP、CK-MB、cTnI水平是影响AMI患者PCI术预后的危险因素(P<0.05);ROC曲线显示,SYNTAX积分、NT-pro BNP、CK-MB、cTnI单独及联合预测AMI患者PCI术预后的AUC分别为0.747、0.754、0.752、0.881、0.952。结论SYNTAX积分、血清NT-pro BNP、CK-MB、cTnI水平单独或联合检测均可有效预测AMI患者PCI术后MACCE的发生,联合检测预测效能显著提升。Objective To explore the value of SYNTAX score combined with levels of serum N-terminal pro-B-type natriuretic peptide(NT-pro BNP),creatine kinase isoenzyme(CK-MB)and cardiac troponin I(cTnI)on the evaluation of prognosis of acute myocardial infarction(AMI)undergoing coronary intervention.Methods 85 patients with AMI who underwent coronary intervention in the hospital were selected as the study subjects.All patients received coronary angiography before surgery.SYNTAX score was used to evaluate the coronary lesion degree,and serum levels of NT-pro BNP,CK-MB and cTnI were measured during hospitalization.At 6 months of follow-up after surgery,the patients were divided into good prognosis group and poor prognosis group according to whether there were main adverse cardiovascular and cerebrovascular events(MACCE)after surgery.The general clinical data,SYNTAX score and serum levels of NT-pro BNP,CK-MB and cTnI were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the influencing factors of prognosis in patients with AMI undergoing coronary intervention,and the evaluated value of SYNTAX score combined with serum levels of NT-pro BNP,CK-MB and cTnI on the prognosis in AMI patients undergoing coronary intervention was analyzed by receiver operating characteristic curve.Results There were no statistical differences in gender,age,BMI,combined with hypertension and diabetes mellitus,stroke history,serum TC,TG,HDL-C,LDL-C,Scr,LVEF,SV,CO and LVEDD between the two groups(P>0.05).There were statistically significant differences in the proportion of history of myocardial infarction,Killip grading,lesion count distribution,stent implantation count,interventionary treatment time and hospital stay between good prognosis group and poor prognosis group(P<0.05).The SYNTAX score and levels of serum NT-pro BNP,CK-MB and cTnI in poor prognosis group were significantly higher than those in good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that the lesion count,stent im

关 键 词：急性心肌梗死 SYNTAX积分 血清N末端钠尿肽原 肌酸激酶同工酶 心肌钙蛋白 诊断价值 

分 类 号：R542.22[医药卫生—心血管疾病]