血清前蛋白转化酶枯草溶菌素9与急性心肌梗死患者经皮冠状动脉介入治疗预后不良的相关性
Correlation between serum proprotein convertase subtilisin/kexin type 9 and poor prognosis of patients with acute myocardial infarction after percutaneous coronary intervention
宋朝国 1刘健 1贺宝臣 1杨伟光1
作者信息
- 1. 056000 河北省邯郸市中心医院心血管外科
- 折叠
摘要
目的 探讨血清前蛋白转化酶枯草溶菌素 9(PCSK9)与急性心肌梗死患者经皮冠状动脉介入治疗(PCI)预后不良的关系.方法 选取 2018 年 6 月至 2021 年 12 月于邯郸市中心医院接受PCI术的急性心肌梗死患者 207 例,随访 1 年将患者分为预后良好组 171 例,预后不良组 36 例.收集患者临床资料并检测PCI术前、术后 1 d、术后 3 d、术后 5 d血清PCSK9、心肌肌钙蛋白I(cTnI)水平;比较预后良好组与预后不良组患者临床资料、不同时间点血清PCSK9、cTnI水平;Logistic回归分析影响急性心肌梗死患者PCI术后预后不良的因素;受试者工作特征曲线评价PCI术后 3 d、术后 5 d血清PCSK9 水平对急性心肌梗死患者PCI术后预后不良的预测价值.结果 预后不良组患者高血压史比例、低密度脂蛋白胆固醇、甘油三酯、PCI术后 3 d和术后 5 d血清PCSK9、cTnI水平高于预后良好组,差异有统计学意义(t/χ2=6.471、14.615、10.698、10.024、30.088、19.299、13.148,P＜0.05);有高血压史、PCI术后 3 d和术后 5 d血清PCSK9水平高是影响急性心肌梗死患者PCI术后预后不良的危险因素[OR(95%CI)=2.614(1.382～4.943)、2.847(1.782～4.548)、2.646(1.487～4.708),P＜0.01];PCI术后 3 d血清PCSK9 水平预测急性心肌梗死患者PCI术后预后不良的曲线下面积(AUC)为 0.871,截断值为 29.34 ng/mL,敏感度为74.71%,特异度为 81.52%;PCI术后 5 d血清PCSK9 水平预测急性心肌梗死患者PCI术后预后不良的AUC为 0.911,截断值为 20.12 ng/mL,敏感度为 85.72%,特异度为 81.93%.结论 监测急性心肌梗死患者PCI术后3 d和术后5 d血清PCSK9水平,对患者不良预后有一定的预测价值.
Abstract
Objective To explore the relationship between serum proprotein convertase subtilisin/kexin type 9(PCSK9)and poor prognosis of patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 207 patients with AMI who underwent PCI in Handan Central Hospital from June 2018 to December 2021 were selected and divided into the good prognosis group(171 cases)and the poor prognosis group(36 cases)after 1-year follow-up.Clinical data of patients were collected,serum PCSK9 and cardiac troponin I(cTnI)levels were mearsured before PCI,1 day after PCI,3 days after PCI,and 5 days after PCI.Clinical data,serum PCSK9 and cTnI levels at different time points were compared between the good prognosis group and the poor prognosis group.Logistic regression analysis was performed to identify influencing factors for poor prognosis after PCI in patients with AMI.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum PCSK9 levels at 3 and 5 days after PCI for poor prognosis in patients with AMI.Results The proportion of hypertension history,levels of low density lipoprotein-cholesterol and triglyceride,and serum levels of PCSK9 and cTnI at 3 and 5 days after PCI in the poor prognosis group were significantly higher than those in the good prognosis group(t/χ2=6.471,14.615,10.698,10.024,30.088,19.299,13.148;P＜0.05).History of hypertension and high serum PCSK9 level at 3 and 5 days after PCI were independent risk factors for the poor prognosis in patients with AMI after PCI[OR(95%CI)=2.614(1.382-4.943),2.847(1.782-4.548),2.646(1.487-4.708);P＜0.01].The area under the curve(AUC)based on the serum PCSK9 level at 3 days after PCI in predicting the poor prognosis of patients with AMI after PCI was 0.871,with a cut-off value of 29.34 ng/mL,sensitivity of 74.71%,and specificity of 81.52%.The AUC based on the serum PCSK9 level at 5 days after PCI in predicting the poor prognosis of patients with AMI after PCI was 0.911,with a cut-off value of 20.12 ng/mL,sensitivity of 85.72%,and specificity of 81.93%.Conclusion Monitoring PCSK9 level at 3 and 5 days after PCI has a high predictive value for poor prognosis of patients with AMI.
关键词
前蛋白转化酶枯草溶菌素9/急性心肌梗死/经皮冠状动脉介入治疗/预后Key words
Proprotein convertase subtilisin/kexin type 9/Acute myocardial infarction/Percutaneous coronary intervention/Prognosis引用本文复制引用
基金项目
河北省医学科学研究项目(20200474)
出版年
2024
国家科技期刊平台
NSTL
万方数据