外周血hs-cTnI联合MR-proADM水平预测急性心肌梗死患者短期预后的价值

Value of hs-cTnI combined with MR-proADM in the peripheral blood in predicting short-term prognosis of acute myocardial infarction patients

目的分析外周血超敏肌钙蛋白I(hs-cTnI)联合肾上腺髓质中段肽(MR-proADM)水平预测急性心肌梗死(AMI)患者短期预后的价值。方法回顾性分析2022年3月至2023年2月期间西安市第九医院收治的81例AMI患者的临床资料,男47例、女34例,年龄26~79(52.37±8.46)岁。统计患者出院后12个月的主要不良心血管事件(MACE),分为预后不良组(发生MACE)和预后良好组(未发生MACE)。统计两组的基线资料,logistic回归分析AMI患者短期预后的影响因素,采用受试者操作特征曲线(ROC)分析血清hs-cTnI、MR-proADM水平对AMI患者短期预后的预测价值。采用χ^(2)检验、独立样本t检验。结果81例AMI患者中预后不良27例,预后良好54例。与预后良好组相比,预后不良组Killip分级Ⅲ级、胸痛、冠脉三支病变发生率及hs-cTnI、MR-proADM水平更高(均P<0.05);多因素logistic回归分析发现,Killip分级Ⅲ级[OR=4.375(1.495~12.801)]、胸痛[OR=3.769(1.400~10.151)]、冠脉三支病变[OR=3.950(1.297~12.030)]、hs-cTnI[OR=4.049(1.414~11.591)]、MR-proADM[OR=1.161(1.082~1.246)]为AMI患者短期预后不良的独立危险因素(均P<0.05)。由ROC可得出:hs-cTnI联合MR-proADM预测AMI患者短期预后不良的曲线下面积(AUC)为0.903,高于hs-cTnI、MR-proADM单一检测(均P<0.05)。结论外周血hs-cTnI联合MR-proADM水平对AMI患者短期预后具有较好的预测效能。

Objective To analyze the value of peripheral blood hypersensitive troponin I(hs-cTnI)combined with mid-regional proadrenomedullin(MR-proADM)in predicting short-term prognosis of acute myocardial infarction(AMI)patients.Methods The clinical data of 81 AMI patients admitted to Xi'an Ninth Hospital from March 2022 to February 2023 were retrospectively analyzed.There were 47 males and 34 females,aged 26-79(52.37±8.46)years.The major adverse cardiovascular events(MACE)within 12 months after discharge were statistically analyzed,and the patients were divided into a poor prognosis group(MACE)and a good prognosis group(non-MACE).The baseline data of the two groups were analyzed,and the factors influencing the short-term prognosis of AMI patients were analyzed by logistic regression analysis.The predictive value of serum hs-cTnI and MR-proADM for short-term prognosis of AMI patients was analyzed by receiver operating characteristic curve(ROC).χ^(2) test and independent sample t test were used.Results Among the 81 patients with AMI,27 cases had poor prognosis and 54 cases had good prognosis.Compared with the good prognosis group,the rates of Killip gradeⅢ,chest pain,and three-vessel coronary artery lesions and the levels of hs-cTnI and MR-proADM in the poor prognosis group were higher(all P<0.05).Multivariate logistic regression analysis found that Killip gradeⅢ[OR=4.375(1.495,12.801)],chest pain[OR=3.769(1.400,10.151)],three-vessel coronary artery lesions[OR=3.950(1.297,12.030)],hs-cTnI[OR=4.049(1.414,11.591)],and MR-proADM[OR=1.161(1.082,1.246)]were independent risk factors for poor short-term prognosis in AMI patients(all P<0.05).According to the ROC,the area under the curve(AUC)of hs-cTnI combined with MR-proADM in predicting poor short-term prognosis of AMI patients was 0.903,which was significantly higher than that of hs-cTnI and MR-proADM(both P<0.05).Conclusion hs-cTnI combined with MR-proADM in the peripheral blood can predict the short-term prognosis of AMI patients.