急性心肌梗死患者PCI术后血浆ApoE、视黄醇结合蛋白变化对不良心血管事件的预测价值  

Predictive value of plasma ApoE and retinol binding protein changes after PCI for adverse cardiovascular events in patients with acute myocardial infarction

作　　者：雷珂[1] 陈栋 崔晗 LEI Ke;CHEN Dong;CUI Han(Department of Clinical Laboratory,Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an,Shaanxi 710004,China;Department of Clinical Laboratory,Xi’an Fengcheng Hospital,Xi’an,Shaanxi 710016,China)

机构地区：[1]西安交通大学第二附属医院检验科,西安710004 [2]西安凤城医院检验科,西安710016

出　　处：《重庆医学》2024年第24期3739-3743,共5页Chongqing Medical Journal

基　　金：陕西省自然科学基础研究计划项目(2021JQ-738)。

摘　　要：目的分析急性心肌梗死(AMI)患者经皮冠状动脉介入术(PCI)术后血浆载脂蛋白E(ApoE)、视黄醇结合蛋白(RBP)变化对不良心血管事件(MACE)的预测价值。方法选择西安交通大学第二附属医院2021年4月至2022年12月收治的85例行PCI治疗的AMI患者为研究对象。于PCI术后采取酶联免疫吸附法检测RBP水平,用乳胶增强免疫比浊法检测ApoE水平。采用电话或上门随访的方式对术后1年患者MACE的发生情况进行收集,并将其分为两组,将发生MACE纳入发生组,将未发生MACE纳入未发生组。对比两组基础资料,分析AMI患者PCI术后发生MACE的影响因素及ApoE、RBP水平预测AMI患者PCI术后发生MACE的效能。结果85例AMI患者PCI术后有14例(16.47%)发生MACE,其中再次血运重建有6例,严重心律失常3例,严重心力衰竭5例;未发生MACE有71例(83.53%)。发生组LVEF低于未发生组,ApoE、RBP水平、Killip分级为Ⅲ~Ⅳ级患者所占比例高于未发生组(P<0.05)。logistic回归分析结果显示,ApoE、RBP水平升高,Killip分级为Ⅲ~Ⅳ级是预测AMI患者PCI术后发生MACE的危险因素,LVEF升高是预测AMI患者PCI术后发生MACE的保护因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,LVEF、ApoE、RBP、Killip分级单独及联合预测AMI患者PCI术后发生MACE的灵敏度分别为71.43%、78.57%、78.57%、71.43%、92.86%;特异度分别为74.65%、81.69%、77.46%、70.42%、91.55%,联合检测预测价值较高。结论ApoE、RBP水平是AMI患者行PCI术后MACE发生的影响因素,联合LVEF、Killip分级可更好地预测AMI患者行PCI术后MACE发生情况。Objective To analyze the predictive value of plasma apolipoprotein E(ApoE)and retinol-binding protein(RBP)changes on adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in the patients with acute myocardial infarction(AMI).Methods A total of 85 patients with AMI undergoing PCI in the Second Affiliated Hospital of Xi’an Jiaotong University from April 2021 to December 2022 were selected as the study subjects.After PCI,the enzyme-linked immunosorbent assay was used to detect the RBP level and the latex-enhanced immunoturbidimetry was used to detect the ApoE level.The incidence situation of MACE in the patients with 1-year follow-up was followed up by telephone or on-site method.The patients were divided into the two groups,the patients with MACE occurrence were included in the occurrence group and those without MACE occurrence were in the non-occurrence group.The basic data were compared between the two groups.The influencing factors of ApoE combined with RBP in predicting the occurrence of MACE after PCI in AMI patients were analyzed and the efficiency of ApoE and RBP levels in predicting MACE occurrence after PCI in AMI patients was analyzed.Results Among 85 patients with AMI undergoing PCI,14 cases(16.47%)developed MACE,including 6 cases of revascularization,3 cases of severe arrhythmia and 5 cases of severe heart failure.There were 71 cases(83.53%)of non-MACE occurrence.The level of LVEF in the occurrence group was lower than that in the non-occurrence group,and the ApoE and RBP levels and Killip gradeⅢ-Ⅳin the occurrence group were higher than those in the non-occurrence group(P<0.05).The logistic regression analysis results showed that the increase of ApoE and RBP levels and Killip gradeⅢ-Ⅳwere the risk factors for predicting the MACE occurrence after PCI in AMI patients,while the LVEF increase was the protective factor for the MACE occurrence after PCI in AMI patients(P<0.05).The receiver operating characteristic(ROC)curve analysis results showed that the sensitivities of

关 键 词：急性心肌梗死 经皮冠状动脉介入术 载脂蛋白E 视黄醇结合蛋白 不良心血管事件 

分 类 号：R446[医药卫生—诊断学]