Changes in MHR,NGF,and COX-2 before and after intravenous thrombolytic therapy in patients with acute myocardial infarction and their prognostic value
Objective To investigate the changes of nerve growth factor(NGF),monocyte-high-density lipo-protein cholesterol ratio(MHR),and cyclooxygenase-2(COX-2)in patients with acute myocardial infarction(AMI)be-fore and after intravenous thrombolytic therapy and their prognostic value.Methods A retrospective study was con-ducted on 150 patients with AMI who underwent intravenous thrombolysis at Nanyang Central Hospital from January 2022 to August 2023.These patients were divided into a poor prognosis group of 41 cases and a good prognosis group of 109 cases based on their prognosis at 6 months after treatment.The general data of the two groups of patients and the lev-els of MHR,NGF,and COX-2 before and after treatment were compared.Pearson method was used to analyze the corre-lation between the levels of MHR,NGF,and COX-2 before treatment and the Gensini score.Multivariate logistic regres-sion analysis was used to analyze the factors affecting the poor prognosis of AMI patients.Receiver operating characteris-tic(ROC)curve and area under the curve(AUC)were used to evaluate the value of predicting poor prognosis after treat-ment with MHR,NGF,and COX-2 levels.Results The age,the proportion of patients with onset to thrombolysis time≥6 hours,the proportion of diabetes,and the Gensini score before treatment in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05):(63.27±7.39)years vs(57.64±6.51)years,43.90%vs 19.27%,41.46%vs 16.51%,(56.15±17.46)points vs(45.37±14.19)points.The MHR,NGF,and COX-2 levels in the poor progno-sis group before and after treatment were 0.95±0.31 and 0.62±0.20,(19.65±4.29)pg/mL and(13.71±3.59)pg/mL,and(421.54±104.68)ng/L and(287.69±75.31)ng/L,respectively,significantly higher than 0.64±0.20 and 0.39±0.12,(16.31±3.78)pg/mL and(8.24±2.63)pg/mL,and(360.62±95.79)ng/L and(215.83±59.42)ng/L in the good prognosis group(P<0.05).Pearson analysis revealed that the levels of MHR,NGF,and COX-2 in AMI patients before treatment were posi-tively correlated with the Gensini score(r=0.517,0.468,0.450,P<0.05).The results of the multivariate logistic regres-sion analysis showed that age,time from onset to thrombolysis,diabetes,Gensini score before treatment,and MHR,NGF,and COX-2 levels before and after treatment were all factors that negatively affected prognosis(P<0.05).ROC analysis showed that the AUC of MHR,NGF,and COX-2 after treatment in combination for predicting poor prognosis after treatment was 0.924(95%CI:0.869 to 0.961),which was significantly higher than that of each indicator alone(P<0.05).Conclusion The high levels of MHR,NGF,and COX-2 in patients with AMI are closely related to the prognosis after intravenous thrombolytic therapy.The combined detection of MHR,NGF,and COX-2 after treatment can help pre-dict the prognosis of patients with AMI and can be used as an indicator for evaluating the prognosis of AMI.
Monocyte to high density lipoprotein cholesterol ratioNerve growth factorCycloxygenase-2Acute myocardial infarctionIntravenous thrombolysis
万方数据
维普
