血清Cystatin C、MMP-2及hs-CRP/PAB对急性心肌梗死患者PCI术后并发心衰的预测价值

Predictive value of serum Cystatin C,MMP2 combined with hs CRP/PAB ratio in patients with acute myocardial infartion complicated by heart failure after PCI

目的探究血清胱抑素C(Cystatin C)、基质金属蛋白酶-2(MMP-2)及超敏C-反应蛋白/前白蛋白(hsCRP/PAB)比值联合应用对急性心肌梗死(AMI)患者术后并发心衰(HF)的预测价值。方法回顾性分析143例AMI行PCI术患者和32例健康体检者的临床资料(正常对照组),将AMI患者分为2组,其中术后无HF患者65例(无HF组),术后并发HF患者78例(HF组),检测所有受试者血清中Cystatin C、MMP-2水平及hs-CRP/PAB比值。结果HF组血清中Cystatin C、MMP-2、hs-CRP水平以及hs-CRP/PAB显著高于正常对照组和无HF组(P <0. 05),HF组血清中PAB的水平显著低于正常对照组和无HF组(P <0. 05); AMI术后并发HF患者血清中Cystatin C、MMP-2以及hs-CRP/PAB与尿酸、Scr、Bun、SBP、DBP、c Tn T、CK-MB呈正相关(P <0. 05);且Cystatin C、MMP-2、hs-CRP/PAB、SBP、DBP、c Tn T、CK-MB是AMI术后并发HF的独立危险因素; ROC曲线分析表明,Cystatin C、MMP-2、hs-CRP/PAB以及3项联合检测对AMI术后并发HF预测的曲线下面积(AUC)为分别为0. 672、0. 687、0. 692、0. 854。结论 Cystatin C、MMP-2及hs-CRP/PAB比值联合检测在预测AMI术后并发HF中具有较高的应用价值,因此可以作为AMI术后并发HF诊断和治疗的血清标志物。

Objective To investigate the predictive value of combined detection of serum cystatin C(Cystatin C),matrix metalloproteinase 2(MMP-2)and hypersensitivity C reactive protein/prealbumin(hs-CRP/PAB)ratio in patients with acute myocardial infartion complicated by heart failure after percutanous coronary intervention(PCI).Methods The clinical data about 143 patients with AMI complicated by HF after PCI and 32 healthy subjects(control group)were retrospectively analyzed.The patients with AMI were divided into non-HF group(n=65)and HF group(n=78).The serum levels of Cystatin C,MMP-2 and the ratio of hs CRP/PAB were detected for all the subjects.Results The serum levels of Cystatin C,MMP-2 and hs CRP and hs-CRP/PAB ratio in HF group were significantly higher than those in control group and non-HF group(P<0.05),however,the serum levels of PAB were significantly lower than those in control group and non-HF group(P<0.05).Moreover,the serum levels of Cystatin C,MMP-2 and hs CRP/PAB in HF group were positively correlated with those of uric acid,Scr,Bun,SBP,DBP,cTnT and CK MB(P<0.05),and Cystatin C,MMP-2,hs-CRP/PAB,SBP,DBP,cTnT,CKMB were independent risk factors for patients with AMI complicated by HF after PCI.In addition,the ROC curve analysis showed that the area under the predicted curve(AUC)of Cystatin C,MMP-2,hs-CRP/PAB ratio and the combination detection of the three indexes were 0.672,0.687,0.692 and 0.854,respectively.Conclusion The combined detection of Cystatin C,MMP-2 and hs-CRP/PAB rato is highly valuable in predicting incidence of HF in patients with AMI after PCI,therefor,which can be regarded as the serum markers for diagnosis and treatment of HF in patients with AMI after PCI.