| 周拥志,彭筱平,赵 彬,夏小鹏,郭楚锋.血清CX3CL1、APN、Hcy及hs-CRP水平对急性心肌梗死患者PCI术后心肌低灌注的预测价值及其模型构建[J].,2023,(10):1934-1939 |
| 血清CX3CL1、APN、Hcy及hs-CRP水平对急性心肌梗死患者PCI术后心肌低灌注的预测价值及其模型构建 |
| Predictive Value of Serum CX3CL1, APN, Hcy and hs-CRP Levels on Myocardial Hypoperfusion after PCI in Patients with Acute Myocardial Infarction and its Model Construction |
| 投稿时间：2022-11-17 修订日期：2022-12-13 |
| DOI：10.13241/j.cnki.pmb.2023.10.025 |
| 中文关键词: 急性心肌梗死 经皮冠状动脉介入治疗 心肌低灌注 CX3CL1 APN Hcy hs-CRP 预测价值 模型构建 |
| 英文关键词: Acute myocardial infarction Percutaneous coronary intervention Myocardial hypoperfusion CX3CL1 APN Hcy hs-CRP Predictive value Model construction |
| 基金项目:湖南省卫生计生委科研计划项目（C2016004） |
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| 中文摘要: |
| 摘要 目的：探讨血清CX3C趋化因子配体1 （CX3CL1）、脂联素（APN）、同型半胱氨酸（Hcy）及超敏C反应蛋白（hs-CRP）水平对急性心肌梗死（AMI）患者经皮冠状动脉介入治疗（PCI）术后心肌低灌注的预测价值，并构建其预测模型。方法：选择2020年10月至2022年4月我院行PCI术治疗的AMI患者106例，根据患者术后冠状动脉血流分级结果将其分为正常灌注组（n=82）和低灌注组（n=24），比较两组临床资料、PCI治疗情况及血清CX3CL1、APN、Hcy及hs-CRP水平。应用单因素和多因素Logistic回归分析PCI术后心肌低灌注的相关因素，并构建AMI患者PCI术后心肌低灌注预测模型，应用受试者工作特征（ROC）曲线分析新模型及各指标对AMI患者PCI术后心肌低灌注的预测价值。结果：低灌注组年龄显著高于正常灌注组，左心室射血分数（LVEF）显著低于正常灌注组（P<0.05）。低灌注组血清CX3CL1、Hcy及hs-CRP水平显著高于正常灌注组，APN水平显著低于正常灌注组（P<0.05）。多因素Logistic回归分析显示，年龄≥62.62岁、LVEF≤59.05%、血清CX3CL1≥1954.37 ng/mL、血清APN≤6.69 μg/L、血清Hcy≥11.86 μg/mL、血清hs-CRP≥5.18 mg/L是心肌梗死患者PCI术后心肌低灌注的危险因素（P＜0.05）。ROC曲线分析显示基于血清CX3CL1、APN、Hcy及hs-CRP建立的预测模型对PCI术后心肌低灌注有较高的敏感度、特异度。结论：血清CX3CL1、Hcy、hs-CRP水平增高及APN水平降低是心肌梗死PCI术后心肌低灌注的危险因素，基于以上指标构建的预测模型对心肌梗死PCI术后心肌低灌注的预测具有一定价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the predictive value of serum CX3C chemokine ligand 1 (CX3CL1), adiponectin (APN), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) levels on myocardial hypoperfusion after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction, and to construct its predictive model. Methods: 106 patients with AMI who underwent PCI in our hospital from October 2020 to April 2022 were selected, and they were divided into normal perfusion group (n=82) and low perfusion group (n=24) according to the results of postoperative coronary blood flow classification. The clinical data, PCI treatment and serum CX3CL1, APN, Hcy and hs-CRP levels in the two groups were compared. Univariate and multivariate Logistic regression were used to analyze the related factors of myocardial hypoperfusion after PCI, and the prediction model of myocardial hypoperfusion after PCI in patients with AMI was constructed. The predictive value of the new model and each index for myocardial hypoperfusion after PCI in patients with AMI was analyzed by receiver operating characteristic (ROC) curve. Results: The age in the low perfusion group was significantly higher than that in the normal perfusion group, and the left ventricular ejection fraction (LVEF) was significantly lower than that in the normal perfusion group (P<0.05). The serum CX3CL1, Hcy and hs-CRP levels in the low perfusion group were significantly higher than those in the normal perfusion group, and the APN level was significantly lower than that in the normal perfusion group(P<0.05). Multivariate Logistic regression analysis showed that age≥62.62 years, LVEF≤59.05%, serum CX3CL1≥1954.37 ng/mL, serum APN≤6.69 μg/L, serum Hcy≥11.86 μg/mL, serum hs-CRP≥5.18 mg/L were risk factor for myocardial hypoperfusion in patients with myocardial infarction after PCI(P<0.05). ROC curve analysis showed that the prediction model based on serum CX3CL1, APN, Hcy and hs-CRP had high sensitivity and specificity to myocardial hypoperfusion after PCI. Conclusion: The increase of serum CX3CL1, Hcy, hs-CRP levels and the decrease of APN level are the risk factors of myocardial hypoperfusion after PCI for myocardial infarction, the prediction model built based on the above indexes has certain value for the prediction of myocardial hypoperfusion after PCI. |
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