血清不规则趋化因子、胱抑素C浓度与急性心肌梗死患者心室重构的相关性
Correlation between Serum Concentrations of Fractalkine,Cystatin C and Ventricular Remodeling in Patients with Acute Myocardial Infarction
邬玉璐 1钱改河 2叶承刚3
作者信息
- 1. 天长市人民医院普内科,安徽天长 239399
- 2. 天长市人民医院神经内科,安徽天长 239399
- 3. 天长市人民医院心内科,安徽天长 239399
- 折叠
摘要
目的 观察急性心肌梗死(acute myocardial infarction,AMI)患者血清不规则趋化因子(fractalkine,FKN)、胱抑素C(Cystatin C,Cys C)浓度及心室重构的发生情况,并分析血清FKN、Cys C浓度与AMI患者发生心室重构的相关性.方法 选择2020年5月至2021年5月天长市人民医院144例AMI患者作为研究对象,入院后患者均实施经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗,全部患者治疗后均接受为期6个月的随访,观察晚期心室重构发生情况并分为发生组与未发生组,比较两组患者基线资料和实验室指标(血清FKN、Cys C浓度),并分析血清FKN、Cys C浓度与晚期心室重构发生的关系.结果 相较于入院1周内,完成PCI治疗后6个月两组患者的左心室舒张末期容积(left ventricular end-diastolic volume,LVEDV)增大,差异有统计学意义(P<0.001).本研究中144例AMI患者心室重构发生率为25.69%(37/144).Logistic回归分析结果显示,入院时血清B型脑钠肽(brain natriuretic peptide,BNP)、FKN、Cys C浓度和随访3个月时血清FKN、Cys C浓度高可能是AMI患者晚期心室重构发生的风险因子(OR>1,P<0.05).绘制受试者工作特征曲线(receiver operating characteristic curve,ROC),结果显示,入院时血清FKN浓度、入院时血清Cys C浓度、随访3个月时血清FKN浓度、随访3个月时血清Cys C浓度预测AMI患者晚期心室重构的曲线下面积(area under the curve,AUC)分别为0.809、0.714、0.897、0.764,均有一定预测价值.绘制决策曲线,结果显示,在阈值0.0～1.0范围内,联合入院时、随访3个月时血清FKN、Cys C浓度预测AMI患者晚期心室重构的净受益率高于单独某一指标,净受益率最大值为0.257.结论 AMI患者血清FKN、Cys C浓度与晚期心室重构的发生有关,入院时、随访3个月时血清FKN、Cys C浓度预测AMI患者晚期心室重构具有一定价值,联合各指标可获得较高的净受益率.
Abstract
Objectives To observe the serum concentrations of fractalkine(FKN),cystatin C(Cys C)and ventricular remodeling in patients with acute myocardial infarction(AMI),and to analyze the correlation between the serum concen-trations of FKN and Cys C and ventricular remodeling in patients with AMI.Methods A total of 144 patients with AMI in Tianchang People's Hospital from May 2020 to May 2021 were selected as the study subjects,and received percutane-ous coronary intervention(PCI)after admission.All the patients were followed up for 6 months after treatment,then their occurrence of late ventricular remodeling was observed and they were divided into occurrence group and non occur-rence group.The basic data and laboratory indexes(serum concentrations of FKN and Cys C)of the two groups were compared,and the relationship between the serum concentrations of FKN and Cys C and the late ventricular remodeling was analyzed.Results Compared with that within 1 week after admission,the average left ventricular end-diastolic vol-ume(LVEDV)increased 6 months after PCI in the two groups,and the differences were statistical significant(P<0.001).In this study,the incidence of ventricular remodeling in 144 patients with AMI was 25.69%(37/144).The re-sults of Logistic regression analysis showed that,the high serum concentrations of B-type natriuretic peptide(BNP),FKN,Cys C at admission and serum concentrations of FKN and Cys C at 3 months follow-up might be the risk factors of late ventricular remodeling in patients with AMI(OR>1,P<0.05).The receiver operating characteristic curve(ROC)was drawn,and the results showed that,the area under the curve(AUC)of FKN at admission,Cys C at admission,FKN at 3 months of follow-up and Cys C at 3 months of follow-up were 0.809,0.714,0.897 and 0.764 respectively,which had certain predictive value.The decision curve was drawn,and the results showed that,within the threshold range of 0.0-1.0,the combined serum concentrations of FKN and Cys C at admission and 3 months of follow-up in predicting the net benefit rate of late ventricular remodeling in patients with AMI was higher than a single index,and the maximum net benefit rate was 0.257.Conclusions The serum concentrations of FKN and Cys C in patients with AMI is related to the occurrence of late ventricular remodeling.The serum concentrations of FKN and Cys C at admission and follow-up for 3 months is of cer-tain value in predicting late ventricular remodeling in patients with AMI,and combining all indicators can obtain a higher net benefit rate.
关键词
心肌梗死/心室重构/不规则趋化因子/胱抑素CKey words
myocardial infarction/ventricular remodeling/irregular chemokine/cystatin C引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据