血清三种因子与急性心肌梗死患者PCI后MACE风险间的关系

    Relationship between three serum factors and the risk of MACE after PCI in patients with acute myocardial infarction

      摘要
    • 摘要:
      目的 探讨血清B型脑钠肽（BNP）、心肌肌钙蛋白I（cTnI）和胱抑素C（Cys-C）与急性心肌梗死患者经皮冠脉介入术（PCI）后主要不良心血管事件（MACE）发生风险的相关性。
      方法 回顾性分析2018年1月～2022年12月于芜湖市中医医院行PCI术治疗的124例急性心肌梗死患者的临床资料，按照术后60 d是否发生MACE分为两组，对比两组临床资料及血清指标，通过ROC曲线分析冠脉病变支数、BNP、cTnI与Cys-C预测急性心肌梗死患者PCI术后60 d发生MACE的价值，再将两组有差异信息纳入多因素Logistic回归分析，行量化赋值，明确急性心肌梗死患者PCI术后60 d发生MACE的危险因素。
      结果 两组年龄、性别、体重指数（BMI）、基础合并症、家族史、吸烟史、饮酒史、发病至就诊时间、疾病类型对比差异均无统计学意义，发生MACE组冠脉病变支数多于未发生MACE组（P<0.01）；发生MACE组BNP、cTnI与Cys-C水平均高于未发生MACE组（均P<0.01）；经ROC曲线分析证明，冠脉病变支数、BNP、cTnI与Cys-C均能用于急性心肌梗死患者PCI术后60 d发生MACE的预测，曲线下面积分别为0.701（P<0.01）、0.624（P<0.05）、0.736（P<0.01）和0.734（P<0.01）；经多因素Logistic回归分析证实冠脉病变支数≥3支、BNP≥87.12 pg/ml、cTnI≥4.73 μg/L和Cys-C≥2.81 mg/L是急性心肌梗死患者PCI术后60 d发生MACE的危险因素。
      结论 急性心肌梗死患者PCI术后60 d发生MACE与BNP、cTnI、Cys-C水平异常升高有关，是MACE发生的重要危险因素，临床可通过检测上述指标评估患者预后情况。

       

      Abstract:
      AIM To investigate the correlation between serum B type brain natriuretic peptide (BNP), myocardial troponin I (cTnI) and cystatin C (Cys-C) and the risk of cardiovascular adverse events (MACE) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction.
      METHODS Clinical data of 128 patients with acute myocardial infarction who underwent PCI in our hospital from January 2018 to December 2022 were retrospectively analyzed, and the patients were divided into two groups according to whether MACE occurred 60 days after surgery. Clinical data and serum indexes of the two groups were compared. The value of predicting the occurrence of MACE in patients with acute myocardial infarction after PCI was analyzed by ROC based on the number of coronary lesions, BNP, cTnI and Cys-C. Then, the difference information of the two groups was incorporated into multivariate logistic regression analysis, and quantification was performed to determine the risk factors of MACE in patients with acute myocardial infarction after PCI.
      RESULTS There was no statistically significant difference in age, gender, body mass index (BMI), underlying comorbidities, family history, smoking history, drinking history, time from onset to treatment, and disease type between the two groups. The number of coronary artery lesions in the MACE group was higher than that in the non MACE group (P<0.01); The levels of BNP, cTnI, and Cys-C in the group with MACE were higher than those in the group without MACE (all P<0.01); According to ROC analysis, the number of coronary artery lesions, BNP, cTnI, and Cys-C can all be used to predict MACE in patients with acute myocardial infarction 60 days after PCI. The area under the curve is 0.701 (P<0.01), 0.624 (P<0.05), 0.736 (P<0.01), and 0.734 (P<0.01), respectively; Multiple logistic regression analysis confirmed that the number of coronary artery lesions ≥ 3, BNP ≥ 87.12 pg/mL, cTnI ≥ 4.73 μ G/L and Cys-C ≥ 2.81 mg/L are risk factors for MACE in patients with acute myocardial infarction 60 days after PCI.
      CONCLUSION The occurrence of MACE in patients with acute myocardial infarction after PCI is associated with abnormal increase of BNP, cTnI and Cys-C levels, which are important risk factors for the occurrence of MACE. It is possible to evaluate the prognosis of patients by detecting the above indicators.

       

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