血清HMGB1、TNF-α及HSP70预测经皮冠状动脉介入术后主要不良心血管事件的价值  

Serum HMGB1,TNF-αand HSP70 levels in predicting major adverse cardiovascular events in patients after percutaneous coronary intervention

作　　者：张言涛[1] 郑剑武 ZHANG Yantao;ZHENG Jianwu(The First Department of Surgery,Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310007,China)

机构地区：[1]杭州市中医院外一科,310007 [2]杭州市中医院心内科,310007

出　　处：《浙江医学》2024年第23期2541-2544,2552,共5页Zhejiang Medical Journal

摘　　要：目的分析高迁移率族蛋白B1(HMGB1)、TNF-α及热休克蛋白70(HSP70)预测急性ST段抬高心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)后发生主要不良心血管事件(MACE)的价值。方法回顾性选取2019年5月至2022年5月杭州市中医院收治的急性STEMI患者104例,均接受PCI治疗,术后随访6个月,依据患者是否发生MACE(包括死亡、术后心绞痛、室性心动过速、心室颤动等)分为MACE组(41例)和非MACE组(63例)。比较两组患者的临床资料及血清血尿素(BUN)、血肌酐(Scr)、TC、TG、HMGB1、TNF-α、HSP70水平。采用多因素logistic回归分析STEMI患者PCI后发生MACE的影响因素。采用ROC曲线分析HMGB1、TNF-α、HSP70预测STEMI患者PCI后发生MACE的效能。结果MACE组患者年龄≥60岁、罪犯血管为右冠状动脉占比及血清HMGB1、TNF-α、HSP70水平均高于非MACE组(均P<0.05)。多因素logistic回归分析显示,年龄(≥60岁)、罪犯血管为右冠状动脉、血清HMGB1、TNF-α、HSP70水平升高均为STEMI患者PCI后发生MACE的危险因素(均P<0.05)。ROC曲线结果显示,HMGB1、TNF-α、HSP70预测STEMI患者PCI后发生MACE的AUC分别为0.796、0.884、0.911(均P<0.05)。结论血清HMGB1、TNF-α、HSP70水平升高是STEMI患者PCI后发生MACE的危险因素,临床医生应密切关注这些指标的异常变化。Objective To invesgate the value of serum high mobility group protein B1(HMGB1),TNF-αand heat shock protein 70(HSP70)levels in predicting major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 104 patients with acute STEMI admitted to Hangzhou Hospital of Traditional Chinese Medicine from May 2019 to May 2022 were included.All patients received PCI treatment and were followed up for 6 months after surgery.Based on whether the patients experienced MACE(including death,postoperative angina,ventricular tachycardia,ventricular fibrillation),patients were divided into MACE group(n=41)and non-MACE group(n=63).The clinical data and serum levels of blood urea nitrogen(BUN),serum creatinine(Scr),TC,TG,HMGB1,TNF-α,and HSP70 were compared between two groups.The risk factors of MACE in STEMI patients after PCI were analyzed with multivariate logistic regression analysis.The value of serum HMGB1,TNF-αand HSP70 levels for predicting MACE in STEMI patients after PCI was analyzed with ROC curve.Results MACE group had a higher proportion of patients aged≥60 years,with the culprit vessel being the right coronary artery,and higher levels of serum HMGB1,TNF-α,and HSP70 than the non-MACE group(all P<0.05).Multivariate logistic regression analysis showed that age≥60 years,the culprit vessel being the right coronary artery,high levels of serum HMGB1,TNF-α,and HSP70 were independent risk factors for MACE in STEMI patients after PCI(all P<0.05).The ROC curve showed that the AUC of HMGB1,TNF-α,and HSP70 for predicting MACE in STEMI patients after PCI were 0.796,0.884,and 0.911,respectively(all P<0.05).Conclusion Elevated serum levels of HMGB1,TNF-α,and HSP70 are risk factors for MACE in STEMI patients after PCI,and clinical physicians should closely monitor the abnormal changes in these indicators.

关 键 词：经皮冠状动脉介入术 急性ST段抬高心肌梗死 肿瘤坏死因子-α 热休克蛋白70 

分 类 号：R542.22[医药卫生—心血管疾病]