急性心肌梗死患者血清Arg-1、ADAMTS-9、Ectodysplasin A水平与PCI术后心功能的关系及对MACE发生的预测价值  

Relationship between serum Arg-1,ADAMTS-9 and Ectodysplasin A levels and cardiac function after PCI in patients with acute myocardial infarction and their predictive value for MACE

作　　者：张红玲 田晓星 马胜川 程佩 田自开 ZHANG Hongling;TIAN Xiaoxing;MA Shengchuan;CHENG Pei;TIAN Zikai(Department of Emergency,Third Medical Center of People′s Liberation Army General Hospital,Beijing 100069,China;Department of Cardiovascular,Handan Jize County Hospital,Handan,Heibei 057350,China)

机构地区：[1]解放军总医院第三医学中心急诊科,北京100069 [2]邯郸市鸡泽县医院心血管内科,河北邯郸057350

出　　处：《国际检验医学杂志》2025年第5期605-609,共5页International Journal of Laboratory Medicine

摘　　要：目的探讨急性心肌梗死(AMI)患者血清精氨酸酶-1(Arg-1)、血栓反应蛋白基序9(ADAMTS-9)、外泌素A(Ectodysplasin A)水平与经皮冠状动脉介入治疗(PCI)术后心功能的关系及对主要不良心血管事件(MACE)发生的预测价值。方法选择2021年1月至2023年12月解放军总医院第三医学中心收治的102例行PCI的AMI患者作为AMI组,另招募同期体检健康者110例作为对照组,采用酶联免疫吸附试验检测血清Arg-1、ADAMTS-9、Ectodysplasin A水平,采用彩色超声诊断仪行超声心动图检查,计算左心室质量指数(LVMI);根据患者是否发生MACE,分为MACE组(32例)和非MACE组(70例);AMI患者血清Arg-1、ADAMTS-9、Ectodysplasin A水平与PCI术后LVMI水平的相关性采用Pearson相关分析;受试者工作特征(ROC)曲线分析血清Arg-1、ADAMTS-9、Ectodysplasin A水平对AMI患者PCI术后发生MACE的预测价值,曲线下面积(AUC)比较行Z检验;多因素Logistic回归分析影响AMI患者发生MACE的因素。结果与对照组比较,AMI组血清Arg-1、ADAMTS-9、Ectodysplasin A水平升高(P<0.05);AMI患者血清Arg-1、ADAMTS-9、Ectodysplasin A水平与LVMI均呈正相关(P<0.05);非MACE组与MACE组患者的性别、体重指数、收缩压、心率、糖尿病史、舒张压、吸烟史、发病到治疗时间、饮酒史、年龄、病程、LVMI比较,差异无统计学意义(P>0.05);MACE组血清Arg-1、ADAMTS-9、Ectodysplasin A水平均高于非MACE组(P<0.05);Arg-1、ADAMTS-9、Ectodysplasin A都是AMI患者发生MACE的独立危险因素(P<0.05);血清Arg-1、ADAMTS-9、Ectodysplasin A水平预测AMI患者发生MACE的AUC分别为0.821、0.779、0.818、0.950,三者联合预测价值高于单独预测(Z=3.137、3.702、2.699,P=0.002、<0.001、0.007)。结论AMI患者血清Arg-1、ADAMTS-9、Ectodysplasin A水平均升高,三者对AMI患者PCI术后MACE的发生具有一定的预测价值。Objective To investigate the relationship between serum arginase-1(Arg-1),thrombomodulin motif 9(ADAMTS-9),Ectodysplasin A and cardiac function after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI),and their predictive value for major adverse cardiovascular events(MACE).Methods A total of 102 AMI patients who underwent PCI in the Third Medical Center of People′s Liberation Army General Hospital from January 2021 to December 2023 were selected as the AMI group,and 110 healthy people were recruited as the control group.The serum levels of Arg-1,ADAMTS-9 and Ectodysplasin A were detected by enzyme-linked immunosorbent assay.Echocardiography was performed by color Doppler ultrasound,and left ventricular mass index(LVMI)was calculated.Patients were divided into MACE group(n=32)and non-MACE group(n=70)according to the occurrence of MACE.Pearson correlation analysis was used to analyze the correlation between serum Arg-1,ADAMTS-9,Ectodysplasin A levels and LVMI after PCI in AMI patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum Arg-1,ADAMTS-9 and Ectodysplasin A levels for MACE in AMI patients after PCI.Z test was used to compare the area under the curve(AUC).Multivariate Logistic regression analysis was used to analyze the influencing factors of MACE in patients with AMI.Results Compared with the control group,the AMI group had significantly higher serum levels of Arg-1,ADAMTS-9 and Ectodysplasin A(P<0.05).The serum levels of Arg-1,ADAMTS-9 and Ectodysplasin A in patients with AMI were positively correlated with LVMI(P<0.05).There were no significant differences in gender,body mass index,systolic blood pressure,heart rate,history of diabetes,diastolic blood pressure,smoking history,time from onset to treatment,drinking history,age,course of disease,and LVMI between MACE group and non-MACE group(P>0.05).The serum levels of Arg-1,ADAMTS-9 and Ectodysplasin A in the MACE group were higher than those in the non-MACE group(P<0.05)

关 键 词：急性心肌梗死 精氨酸酶-1 血栓反应蛋白基序9 外泌素A 经皮冠状动脉介入治疗 主要不良心血管事件 

分 类 号：R542.2[医药卫生—心血管疾病]