急性心肌梗死患者急诊PCI术前血清METTL3和脂蛋白a表达与术后左心室重构发生的剂量反应关系  

Dose-response relationship between preoperative expressions of methyltransferase-like protein 3 and lipoprotein a and postoperative left ventricular remodeling in patients with acute myocardial infarction undergone emergency percutaneous coronary intervention

作　　者：郑虎 闫杰 党松[2] 叶赫娜拉俊 Zheng Hu;Yan Jie;Dang Song;Yehenalajun(Hospital of Integrated Traditional and Western Medicine of Hubei Province,Wuhan 430015,China;不详)

机构地区：[1]湖北省中西医结合医院,武汉430015 [2]武汉大学人民医院东院心内科,武汉430015

出　　处：《中国循证心血管医学杂志》2024年第11期1369-1373,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：湖北省卫生和计划生育委员会面上项目(WJ2021M152)。

摘　　要：目的分析急性心肌梗死(AMI)患者急诊经皮冠状动脉介入治疗(PCI)术前血清甲基化转移酶样蛋白3(METTL3)、脂蛋白a(Lpa)表达与术后左心室重构(LVR)发生的剂量反应关系。方法采取前瞻性研究,选择2021年4月至2023年4月于湖北省中西医结合医院收治的急诊PCI的AMI患者作为研究对象。采集患者PCI术前静脉血,检测血清METTL3、Lpa水平。患者急诊PCI术后随访1年,根据随访期间LVR发生情况分组并收集基线资料。采用二元Logistics回归分析血清METTL3相对表达量、Lpa水平对AMI患者急诊PCI术后LVR发生的影响;采用接受者操作特征曲线(ROC)评估血清METTL3相对表达量、Lpa水平预测AMI患者急诊PCI术后LVR发生价值;采用样条函数与Logistics回归相结合的限制性立方样条法分析血清METTL3相对表达量、Lpa水平与AMI患者急诊PCI术后LVR发生的剂量反应关系。结果LVR组METTL3相对表达量、Lpa水平高于无LVR组(P<0.05);二元Logistics回归结果显示,血清METTL3相对表达量和Lpa水平升高是AMI患者急诊PCI术后LVR发生的危险因素(OR>1,P<0.05);血清METTL3相对表达量和Lpa水平升高可增加AMI患者急诊PCI术后LVR发生风险,特别是当血清METTL3相对表达量>1.42、Lpa>3.60mmol/L时,AMI患者急诊PCI术后LVR发生风险随METTL3相对表达量和Lpa水平升高而升高。结论AMI患者急诊PCI术前血清METTL3相对表达量和Lpa水平与术后左心室重构密切相关,且术后LVR发生风险随血清METTL3相对表达量和Lpa水平升高而升高。Objective To analyze the dose-response relationship between preoperative expressions of serum methyltransferase-like protein 3(METTL3)and lipoprotein a(Lpa)and postoperative left ventricular remodeling(LVR)in patients with acute myocardial infarction(AMI)undergone emergency percutaneous coronary intervention(PCI).Methods AMI patients undergone emergency PCI were chosen and studied prospectively from Hospital of Integrated Traditional and Western Medicine of Hubei Province from Apr.2021 to Apr.2023.The levels of METTL3 and Lpa were detected in patients before PCI.After followed up for 1 y after PCI,the patients were grouped according to LVR occurrence and baseline materials were collected during follow-up period.The influence of METTL3 and Lpa levels on LVR occurrence was analyzed by using binary Logistics regression analysis in AMI patients after emergency PCI.The predictive value of METTL3 relative expression and Lpa levels to LVR occurrence was analyzed by using ROC curve analysis.The dose-response relationship among METTL3 relative expression,Lpa level and LVR occurrence was analyzed by using the restricted cubic spline method combined with spline function and Logistics regression analysis.Results METTL3 relative expression and Lpa level were higher in LVR group than those in non-LVR group(P<0.05).The results of binary Logistics regression analysis showed that higher METTL3 relative expression and Lpa level were risk factors for LVR occurrence(OR>1,P<0.05).The higher METTL3 relative expression and Lpa level increased the risk of LVR occurrence,especially when METTL3 relative expression>1.42 and Lpa level>3.60 mmol/L.The risk of LVR occurrence increased with the increase of METTL3 relative expression and Lpa level in AMI patients after emergency PCI.Conclusion The preoperative METTL3 relative expression and Lpa level are closely correlated to LVR,and postoperative risk of LVR increases with the increase of METTL3 relative expression and Lpa level in AMI patients undergone emergency PCI.

关 键 词：急性心肌梗死 左心室重构 经皮冠状动脉介入治疗 甲基化转移酶样蛋白3 脂蛋白A 

分 类 号：R542.22[医药卫生—心血管疾病]