| 王 明,杨雪飞,李伟艺,高贞青,陈 静,张梦伟.Selvester QRS心电图评分联合血清Hcy、sST2对急性STEMI患者PCI术后主要心血管不良事件的预测价值[J].,2024,(15):2984-2988 |
| Selvester QRS心电图评分联合血清Hcy、sST2对急性STEMI患者PCI术后主要心血管不良事件的预测价值 |
| Predictive Value of Selvester QRS Electrocardiogram Score Combine with Serum Hcy and sST2 on Major Adverse Cardiovascular Events after PCI in Patients with Acute STEMI |
| 投稿时间：2024-01-27 修订日期：2024-02-23 |
| DOI：10.13241/j.cnki.pmb.2024.15.035 |
| 中文关键词: 急性ST段抬高型心肌梗死 经皮冠脉介入 主要心血管不良事件 Selvester QRS心电图评分 Hcy sST2 |
| 英文关键词: Acute ST-segment elevation myocardial infarction Percutaneous coronary intervention Major adverse cardiovascular events Selvester QRS electrocardiogram score Hcy sST2 |
| 基金项目:山东省医药卫生科技发展计划项目（202003011333） |
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| 中文摘要: |
| 摘要 目的：探讨Selvester QRS心电图评分联合血清同型半胱氨酸（Hcy）、可溶性生长刺激表达因子2（sST2）对急性ST段抬高型心肌梗死（STEMI）患者经皮冠脉介入（PCI）术后主要心血管不良事件（MACE）的预测价值。方法：选择2020年6月至2022年6月山东大学齐鲁医院德州医院收治的189例STEMI患者。所有患者均接受PCI治疗，PCI前接受12导连心电图检查，计算Selvester QRS积分，并检测血清Hcy、sST2水平。PCI后随访6个月，根据MACE发生情况将STEMI患者分为MACE组（51例）和非MACE组（138例）。多因素Logistic回归分析STEMI患者PCI后MACE的影响因素，受试者工作特征（ROC）曲线分析Selvester QRS心电图评分联合血清Hcy、sST2预测STEMI患者PCI后MACE的价值。结果：MACE组Selvester QRS心电图评分、血清Hcy、sST2水平高于非MACE组（P＜0.05）。多因素Logistic回归分析显示Killip分级Ⅲ～Ⅳ级、高NT-proBNP、高Selvester QRS心电图评分、高Hcy、高sST2是STEMI患者PCI后MACE的危险因素（P＜0.05）。Selvester QRS心电图评分、Hcy、sST2预测STEMI患者PCI后MACE的曲线下面积分别为0.845、0.835、0.828，联合预测曲线下面积为0.926，高于单独预测。结论：PCI后发生MACE的STEMI患者Selvester QRS心电图评分和血清Hcy、sST2水平均增高，高Selvester QRS心电图评分和Hcy、sST2与PCI后MACE发病风险增加有关。联合Selvester QRS心电图评分和Hcy、sST2对PCI后MACE具有较好的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the predictive value of Selvester QRS electrocardiogram score combine with serum homocysteine (Hcy) and soluble growth stimulating expression factor 2 (sST2) on major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: 189 STEMI patients admitted to Qilu Hospital of Shandong University Dezhou Hospital from June 2020 to June 2022 were selected. All patients received PCI treatment, 12-lead electrocardiogram was performed before PCI, Selvester QRS score was calculated, and serum Hcy and sST2 levels were detected. Follow-up at 6 months after PCI, STEMI patients were divided into MACE group (51 cases) and non MACE group (138 cases) according to the occurrence of MACE. The influencing factors of MACE after PCI in STEMI patients were analyzed by multivariate Logistic regression analysis, the value of Selvester QRS electrocardiogram score combine with serum Hcy and sST2 in predicting MACE after PCI in STEMI patients were analyzed by receiver operating characteristic (ROC) curve. Results: Selvester QRS electrocardiogram score, serum Hcy and sST2 levels in MACE group were higher than those in non MACE group (P<0.05). Multivariate Logistic regression analysis showed that Killip grade III-IV, high NT-proBNP, high Selvester QRS electrocardiogram score, high Hcy and high sST2 were risk factors for MACE after PCI in STEMI patients (P<0.05). The area under the curve of Selvester QRS electrocardiogram score, Hcy and sST2 in predicting MACE after PCI in STEMI patients was 0.845, 0.835 and 0.828 respectively, the area under the curve of combined prediction was 0.926, which was higher than that of single prediction. Conclusion: The Selvester QRS electrocardiogram score and serum Hcy and sST2 levels in STEMI patients with MACE after PCI are increase, high Selvester QRS electrocardiogram score, Hcy and sST2 are associate with an increase risk of MACE after PCI. The combination of Selvester QRS electrocardiogram score, Hcy and sST2 has a good predictive value for MACE after PCI. |
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