文章摘要
张金剑,翁 华,马 慧,赵小芹,周 鑫,王 诚.血清UA、sdLDL、sST2对急性心肌梗死患者PCI术后无复流的预测价值分析[J].,2023,(24):4715-4719
血清UA、sdLDL、sST2对急性心肌梗死患者PCI术后无复流的预测价值分析
Analysis of the Predictive Value of Serum UA, sdLDL and sST2 for No Reflow after PCI in Patients with Acute Myocardial Infarction
投稿时间:2023-04-25  修订日期:2023-05-21
DOI:10.13241/j.cnki.pmb.2023.24.023
中文关键词: 急性心肌梗死  UA  sdLDL  sST2  经皮冠状动脉介入治疗  无复流  预测价值
英文关键词: Acute myocardial infarction  UA  sdLDL  sST2  Percutaneous coronary intervention  No reflow  Prediction
基金项目:2022年度江苏省卫生应急研究所、徐州医科大学医疗卫生应急救援研究中心课题(JSWSYJ-20220304)
作者单位E-mail
张金剑 徐州医科大学研究生院 江苏 徐州 221004睢宁县人民医院心内科 江苏 睢宁 221200 15895240269@163.com 
翁 华 睢宁县人民医院心内科 江苏 睢宁 221200  
马 慧 睢宁县人民医院心内科 江苏 睢宁 221200  
赵小芹 睢宁县人民医院心内科 江苏 睢宁 221200  
周 鑫 睢宁县人民医院心内科 江苏 睢宁 221200  
王 诚 徐州医科大学附属医院心内科 江苏 徐州 221004  
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中文摘要:
      摘要 目的:探讨血清尿酸(UA)、小而密低密度脂蛋白(sdLDL)、可溶性致癌抑制因子2(sST2)对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后无复流(NRF)的预测价值。方法:选取2021年1月~2023年1月睢宁县人民医院收治的196例AMI患者为AMI组,根据PCI术后是否发生NRF分为NRF组和血流正常组,另选取同期120名体检健康志愿者为对照组。比较AMI组与对照组血清UA、sdLDL、sST2水平。采用多因素Logistic回归分析AMI患者PCI术后NRF的影响因素,采用受试者工作特征(ROC)曲线分析血清UA、sdLDL、sST2水平对AMI患者PCI术后NRF的预测价值。结果:与对照组比较,AMI组血清UA、sdLDL、sST2水平升高(P<0.05)。196例AMI患者PCI术后NRF发生率为34.69%,NRF组年龄大于血流正常组,糖尿病比例、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、低密度脂蛋白胆固醇(LDL-C)、UA、sdLDL、sST2水平高于血流正常组(P<0.05)。多因素Logistic回归分析显示,年龄增加和UA、sdLDL、sST2升高为AMI患者PCI术后NRF的独立危险因素(P<0.05)。ROC曲线分析显示,血清UA、sdLDL、sST2水平单独和联合预测AMI患者PCI术后NRF的曲线下面积AUC(0.95CI)分别为0.707(0.481~0.934)、0.742(0.513~0.955)、0.737(0.480~0.970)、0.863(0.737~0.960),联合预测大于单独预测指标。结论:血清UA、sdLDL、sST2水平升高为AMI患者PCI术后NRF的独立危险因素,血清UA、sdLDL、sST2水平联合预测AMI患者PCI术后NRF的价值较高。
英文摘要:
      ABSTRACT Objective: To investigate the predictive value of serum uric acid (UA), small dense low density lipoprotein (sdLDL) and soluble suppression of tumorigenicity 2 (sST2) for no reflow (NRF) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods: 196 AMI patients who were admitted to Suining County People 's Hospital from January 2021 to January 2023 were selected as AMI group, patients were divided into NRF group and normal blood flow group according to whether NRF after PCI, another 120 healthy volunteers who underwent physical examination during the same period were selected as control group. The serum UA, sdLDL, and sST2 levels between the AMI group and the control group were compared. The influencing factors of NRF in AMI patients after PCI were analyzed by multivariate Logistic regression, the predictive value of serum UA, sdLDL and sST2 levels for NRF in AMI patients after PCI were analyzed by receiver operating characteristic (ROC) curve. Results: Compared with control group, the levels of serum UA, sdLDL and sST2 in AMI group were increased (P<0.05). The incidence of NRF in 196 AMI patients after PCI was 34.69 %, the age of NRF group was older than that of normal blood flow group, the proportion of diabetes, creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI), low density lipoprotein cholesterol (LDL-C), UA, sdLDL and sST2 levels were higher than those in normal blood flow group(P<0.05). Multivariate Logistic regression analysis showed that, the increase of age and UA, sdLDL and sST2 were independent risk factors for NRF in AMI patients after PCI (P<0.05). ROC curve analysis showed that, AUC (0.95 CI) of serum UA, sdLDL and sST2 levels alone and in combination for predicting NRF in AMI patients after PCI were 0.707 (0.481~0.934), 0.742 (0.513~0.955), 0.737 (0.480~0.970) and 0.863 (0.737~0.960) respectively, the combined prediction is greater than the individual prediction index. Conclusion: Increase levels of serum UA, sdLDL and sST2 are independent risk factors for NRF in AMI patients after PCI, the combination of serum UA, sdLDL and sST2 levels has a higher value in predicting NRF in AMI patients after PCI.
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