血清半胱氨酸蛋白酶抑制物C与急性心肌梗死泵衰竭和近期预后的相关性

Correlation of serum cystatin C and pump failure and short-term prognosis of patients with acute myocardial infarction

目的研究血清半胱氨酸蛋白酶抑制物C(CysC)与急性心肌梗死(AMI)泵衰竭及近期预后的相关性。方法 AMI患者184例,根据入院后24h内血清CysC的水平分为两组:A组102例,血清CysC为(1.95±0.40)mg/L;B组82例,血清CysC为(1.20±0.20)mg/L。比较两组心功能Killip分级和3个月内病死率,分析血清CysC水平对AMI泵衰竭及近期预后的影响。结果 A组血清CysC水平、Killip分级和近期病死率均高于B组(P<0.05或P<0.01)。生存病例3个月随访期间,A组心血管事件发生率27.7%(23/83),高于B组的13.2%(10/76)(P<0.01)。Logistic回归分析表明,年龄、血清CsyC水平、心功能Killip分级和高血压病为AMI患者住院病死率的相关危险因素(P<0.05或P<0.01);而血清CsyC水平和心功能Killip分级是影响AMI患者3个月内发生严重心血管事件的独立因素(P<0.01)。结论 CysC可能作为AMI患者泵衰竭及近期预后的独立危险因素。

[Abstract] Objective To investigate the correlation of serum cystatin C（CysC） and pump failure and short-term prognosis of patients with acute myocardial infarction（AMI）. Methods On the basis of serum level of CysC, 184 patients with AMI were devided into two groups of A[CysC （1.95±0. 40） mg/L, 102 cases] and B[CysC （1.20±0. 20） mg/L,82 cases]. The grades of Killip and hospital mortality in three months were compared between two groups. The effects of serum level of CysC on the pump failure and short-term prognosis were analyzed. Results Serum level of CysC, Killip grade and death rates in three months were higher in group A than those in group B（P〈0. 05 or P〈0. 01）. The incidence rate of serious cardiovascular events during 3 months follow-up in the survivals was higher in group A than that in group B1-27. 7% （23/83） vs. 13. 2% （10/76）] （P〈0. 01）. Logistic regression analysis showed that elder age, serum level of CysC, Killip grade and hypertention were the risk factors for the mortality in hosipital（P〈0. 05 or P〈0. 01）. Serum level of CsyC and Killip grade were the independent risk factors for serious cardiovascular events in short-term （P〈0. 01 ）. Conclusion Serum level of CysC could be an independent risk factor for the pump failure and short- term prognosis in the patients with AMI.