心脏舒张功能相关指标对急性STEMI患者不良预后的影响  

Cardiac diastolic function-related indicators on the adverse prognosis of patients with acute STEMI

作　　者：陈彩侠 赵中建 CHEN Caixia;ZHAO Zhongjian(Department of Laboratory Medicine,Taihe County People's Hospital,Fuyang Anhui 236600,China)

机构地区：[1]太和县人民医院检验科,安徽阜阳236600 [2]南京医科大学第一附属医院检验学部,江苏南京210029

出　　处：《中国急救复苏与灾害医学杂志》2025年第3期295-299,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省实验诊断学重点实验室基金(ZDXKB2016005)。

摘　　要：目的探讨心脏舒张功能相关指标对急诊过程中接受经皮冠状动脉介入(PCI)治疗的ST段抬高型心肌梗死(STEMI)患者不良预后的影响及其联合预测价值。方法选择2023年3月—2024年4月太和县人民医院收治的急性STEMI患者183例作为研究对象。根据血浆神经肽-Y(NPY)的中位数值,将研究对象分为A组(n=92)和B组(n=91)。收集所有研究对象入院时的基本资料、实验室检查结果以及所有研究对象后续主要不良心血管事件(MACE)状态。通过Logistic回归分析发生MACE的危险因素。结果A组和B组在NPY、年龄、LVEDD、LEVF和肌酸激酶同工酶(CK-MB)方面存在显著性差异(P<0.05)。两组在再梗死、心力衰竭和心源性死亡等方面的发生率具有显著性差异,且B组的MACE总发生率明显高于对照组(P<0.05)。多因素Logistic回归分析表明,NPY、LVEDD、LVEF是MACE的危险因素(P<0.05)。ROC曲线分析结果显示,当LVEDD的截断值为49.500 mm,LVEF的截断值为56.510%,NPY的截断值为227.505 pg/mL时,LVEDD、LVEF、NPY三者联合对MACE发生的预测效能明显高于单一指标的预测效能(P<0.05)。结论在接受急诊PCI治疗的STEMI患者中,NPY水平与MACE发生率呈正相关,LVEDD、LVEF与MACE发生率呈负相关,且三者联合预测MACE发生率具有较高的效能。Objective To study the effects of cardiac diastolic function-related indicators on the adverse prognosis of patients with acuteST-segment elevation myocardial infarction(STEMI)treated with Percutaneous coronary intervention(PCI)andtheir predictive values.Methods A total of 183 cases of acute STEMI patients who admitted to Taihe County People’s Hospital from March 2023 to April 2024 were conducted on this study.All patients were divided into group A(n=92)and group B(n=91)according to the median value of plasma neuropeptide-Y(NPY).Clinical information,laboratory test results at admission,and the status of major adverse cardiovascular events(MACE)were collected and compared between two groups.The independent risk factors for MACE were analyzed by Logistic regression.Results There were significant differences in NPY,age,LVEDD,LEVF and creatine kinase isoenzymes(CK-MB)between groups A and B(P<0.05).There were significant differences in the incidence of re-infarction,heart failure and cardiac death between the two groups,and the total incidence of MACE in group B was significantly higher than that in the control group(P<0.05).Multivariate Logistic regression analysis showed that NPY,LVEDD and LVEF were risk factors for MACE(P<0.05).The results of ROC curve analysis showed that when the cut-off value of LVEDD was 49.500 mm,the cut-off value of LVEF was 56.510%,and the cut-off value of NPY was 227.505 pg/mL,the predictive efficacy of LVEDD,LVEF and NPY on the occurrence of MACE was significantly higher than that of single index(P<0.05).Conclusion In acute STEMI patients receiving emergency PCI,NPY level is positively correlated with the incidence of MACE,while LVEDD and LVEF are negatively correlated with the incidence of MACE.The combined prediction of the three had high value in predicting the incidence of MACE.

关 键 词：经皮冠状动脉介入治疗 血浆神经肽-Y 主要心血管不良事件 

分 类 号：R54[医药卫生—心血管疾病]