Gal-3和sST2评价AMI患者PCI预后的预测价值

董炎炎; 陈魁

doi:10.12125/j.chj.202011093

Gal-3和sST2评价AMI患者PCI预后的预测价值

董炎炎,
陈魁

Predictive value of Gal-3 and sST2 in evaluating PCI prognosis in patients with AMI

摘要

摘要:
目的评价血清中半乳糖凝集素-3（Gal-3）和可溶性生长刺激表达因子2（sST2）对急性心肌梗死（AMI）患者经皮冠状动脉介入（PCI）预后的预测价值。
方法选取2015年8月~2017年10月在郑州大学第一附属医院心内科确诊AMI并行PCI的患者112例，收集患者一般临床资料，并对患者血脂生化指标进行检测。出院后对患者进行3年随访，依据随访患者是否发生主要不良心血管事件（MACE）分为无MACE组（n=34）和MACE组(n=78)，比较两组患者的临床数据。采用Logistic 多因素回归分析MACE的独立危险因素，通过受试者工作特征曲线（ROC）确定血清Gal-3与sST2表达的最佳截断点。
结果两组年龄、性别等一般性资料差别无统计学意义。与无MACE组比较，MACE组患者高血压发生率和超敏C反应蛋白（hs-CRP）显著升高（P<0.05）；总胆固醇（TC）、肌酸激酶同工酶（CK-MB）、sST2和Gal-3均显著升高（P<0.01）；左室射血分数（LVEF）分数显著降低（P<0.01）。多因素Logistic 回归分析发现：高血压、CK-MB、hs-CRP、sST2、Gal-3和LVEF均为MACE发生的独立危险因素（P<0.05）。Gal-3预测MACE的ROC曲线下面积为0.724，截断点为12.57 μg/ml，其敏感度 68%，特异度96%；sST2预测MACE的ROC曲线下面积为0.765，截断点为18.56 ng/ml，其敏感度为74%，特异度为85%。
结论血清Gal-3和 sST2是AMI患者行PCI术后发生MACE的独立危险因素，对AMI行PCI患者预后具有较好的预测价值。

Abstract:
AIM To evaluate the prognostic value of serum galectin-3 (Gal-3) and soluble growth stimulating factor 2 (sST2) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI)
METHODS A total of 112 patients diagnosed with AMI and PCI in the Department of Cardiology, the First Affiliated Hospital of Zhengzhou University from August 2015 to October 2017 were selected. General clinical data of the patients were collected and the biochemical indicators of blood lipids were tested. After discharge, the patients were followed up for 3 years. According to whether the follow-up patients had major adverse cardiovascular events (MACE), they were divided into non-MACE group (n=34) and MACE group (n=78), and the clinical data of the two groups were compared. Logistic multivariate regression analysis was used to analyze the independent risk factors of MACE, and the receiver operating characteristic curve (ROC) was used to determine the best cut-off point of serum Gal-3 and sST2 expression.
RESULTS There was no significant difference in age, gender and other general information between the two groups. Compared with non-MACE group, the incidence of hypertension and hs-CRP in MACE group were significantly increased (P<0.05), the total cholesterol (TC), creatine kinase MB (CK-MB), sST2 and Gal-3 were significantly increased (P<0.01), and the left ventricular ejection fraction (LVEF) was significantly decreased (P<0.01). The multivariate logistic regression analysis showed that hypertension, CK-MB, hs-CRP, sST2, Gal-3 and LVEF were independent risk factors of MACE (P<0.05). Gal-3 predicts the area under the ROC curve of MACE to be 0.724, the cutoff point is 12.57 μg/ml, and its sensitivity is 68%, and its specificity is 96%; sST2 predicts the area under the ROC curve of MACE to be 0.765, and the cutoff point is 18.56 ng/ml, The sensitivity is 74%, and the specificity is 85%.
CONCLUSION Serum Gal-3 and sST2 are independent risk factors for MACE in AMI patients after PCI, and have a good predictive value for the outcome of AMI patients undergoing PCI.

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