实时三维超声心动图参数联合血清和肽素、缺血修饰白蛋白预测急性心肌梗死经皮冠脉介入术治疗预后的价值  

Value of real-time three-dimensional echocardiography parameters combined with copeptin,ischemia-modified albumin in predicting the prognosis of myocardial infarction intervention therapy

作　　者：张玥 刘佳[1] 易娜 菅红伟 ZHANG Yue;LIU Jia;YI Na(Department of Ultrasound,Beijing Daxing District People's Hospital,Beijing 102600,China)

机构地区：[1]北京市大兴区人民医院超声科,北京102600 [2]北京市大兴区人民医院心内科,北京102600

出　　处：《临床和实验医学杂志》2025年第4期425-430,共6页Journal of Clinical and Experimental Medicine

基　　金：北京市适宜技术推广项目(编号:BHTPP202024)。

摘　　要：目的探讨实时三维超声心动图结合血清和肽素、缺血修饰白蛋白(IMA)预测急性心肌梗死(AMI)经皮冠脉介入术治疗预后的价值。方法前瞻性选取2020年1月至2022年1月在北京市大兴区人民医院治疗的急性心肌梗死患者188例作为观察组,同时选取同期健康体检者100名作为对照组。比较观察组和照组血清和肽素和IMA差异,以及观察组不同Gensini评分患者血清和肽素和IMA差异,同时分析观察组发生和未发生主要不良心血管事件(MACE)患者临床资料、超声心动图参数[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左心室收缩末期容积指数(LVESVI)、左心室舒张末期容积指数(LVEDVI)]、和肽素和IMA差异。结果观察组血清和肽素和IMA分别为(7.03±1.03)pmol/L和(98.24±9.91)U/mL,均明显高于对照组[(0.80±0.12)pmol/L和(40.12±9.44)U/mL],差异均有统计学意义(P<0.05)。观察组Gensini评分≥50分患者血清和肽素和IMA分别为(8.82±0.92)pmol/L和(116.85±10.51)U/mL,均明显高于Gensini评分25~49分[(7.11±1.00)pmol/L、(99.24±11.73)U/mL]和≤24分患者[(5.41±0.97)pmol/L、(81.15±10.04)U/mL],差异均有统计学意义(P<0.05)。观察组发生MACE患者Gensini评分、LVEDD、LVESD、LVESVI、LVEDVI、和肽素和IMA分别为(40.41±8.89)分、(50.15±2.21)mm、(35.11±2.16)mm、(28.90±4.40)ml/m^(2)、(53.36±5.03)mL/m^(2)、(7.81±1.00)pmol/L和(115.51±11.14)U/mL,均明显高于未发生MACE患者[(36.62±8.15)分、(48.03±2.51)mm、(32.70±3.03)mm、(23.10±4.60)ml/m^(2)、(46.86±4.95)mL/m^(2)、(6.65±0.91)pmol/L和(89.74±12.03)U/mL],而LVEF为(34.49±4.46)%,明显低于未发生MACE患者[(42.21±5.51)%],差异均有统计学意义(P<0.05)。Logistic回归方程结果显示:Gensini评分、LVEDD、LVESD、LVEF、LVESVI、LVEDVI、和肽素和IMA是患者发生MACE的影响因素(P<0.05),方程预测发生MACE的ROC曲线下面积为0.882(95%CI:0.831~0.933),P<0.05,敏感度和特异度Objective To explore the value of real-time three-dimensional echocardiography combined with copeptin,ischemia-modified albumin(IMA)in predicting the prognosis of myocardial infarction intervention.Methods A total of 188 patients with AMI treated in Beijing Daxing District People's Hospital from January 2020 to January 2022 were prospectively selected as the observation group,and 100 healthy individuals were prospectively selected at the same period as the control group.The differences in serum peptide and IMA between the observation group and the control group,as well as the differences in serum peptide and IMA between patients with different Gensini scores in the observation group were compared.The clinical data,echocardiographic parameters[left ventricular end-diastolic dimension(LVEDD),left ventricular end-systolic dimension(LVESD),left ventricular ejection fraction(LVEF),left ventricular end-systolic volume index(LVESVI),left ventricular end-diastolic volume index(LVEDVI)],and differences in peptide and IMA between patients with and without major adverse cardiovascular events(MACE)in the observation group were also analyzed.Results The serum peptide and IMA levels in the observation group were(7.03±1.03)pmol/L and(98.24±9.91)U/mL,respectively,which were significantly higher than those in the control group[(0.80±0.12)pmol/L and(40.12±9.44)U/mL],the differences were statistically significant(P<0.05).The serum peptide and IMA levels of patients with Gensini scores≥50 in the observation group were(8.82±0.92)pmol/L and(116.85±10.51)U/mL,respectively,which were significantly higher than those of patients with Gensini scores 25-49[(7.11±1.00)pmol/L,(99.24±11.73)U/mL]and≤24[(5.41±0.97)pmol/L,(81.15±10.04)U/mL],the differences were statistically significant(P<0.05).The Gensini score,LVEDD,LVESD,LVESVI,LVEDVI,peptide,and IMA of patients with MACE in the observation group were(40.41±8.89)points,(50.15±2.21)mm,(35.11±2.16)mm,(28.90±4.40)mL/m^(2),(53.36±5.03)mL/m^(2),(7.81±1.00)pmol/L,and(115.51±11.1

关 键 词：实时三维超声心动图 和肽素 缺血修饰白蛋白 急性心肌梗死 预后 

分 类 号：R542.22[医药卫生—心血管疾病] R540.45[医药卫生—内科学]