STEMI患者血清25-(OH)D3水平在急诊直接PCI后ST段回落预测中的价值

Value of Serum 25-(OH)D3 Level in STEMI Patients in the Prediction of ST Segment Fallback after Emergency Direct PCI

目的:探讨急性ST段抬高型心肌梗死(STEMI)患者血清25羟维生素D3(25-(OH)D3)水平在急诊直接PCI(pPCI)后ST段回落(STR)预测中的价值。方法:以某院2016年5月~2018年5月178例STEMI患者为研究对象,PCI术后180min根据患者STR位点分为A组(STR≥50%)和B组(STR<50%),对比两组临床资料、心脏标志物,采用单因素分析、Logistic回归分析方法等确定STR<50%的影响因素。结果:PCI术后180min,147例患者STR≥50%,31例患者STR<50%;B组血清25-(OH)D3、血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTnT)水平均明显高于A组(P<0.05);B组左室射血分数(LVEF)明显低于A组,而其左室舒张末期内径(LVEDD)明显大于A组(P<0.05);Logistic分析显示血清25-(OH)D3含量是STR不良的独立危险因子;受试者工作曲线(ROC)分析显示,血清25-(OH)D3含量对STR不良的敏感度(82.9%)与特异性(72.3%)均较高。结论:血清25-(OH)D3含量是STEMI患者pPCI术后STR不良的独立危险因素,对STR不良具有较高的敏感性和特异性,可以作为STEMI患者STR不良的一个评估指标。

Objective: To investigate the value of serum 25-(OH)D3 level in STEMI patients in the prediction of ST segment fallback after emergency direct PCI. Methods: 178 patients with STEMI in a hospital from May 2016 to May 2018 were enrolled. Atr 180 minutes after PCI, they were divided into group A (STR≥50%) and group B (STR<50%) according to the STR site. Compared the two groups of clinical data and cardiac markers, single factor analysis and Logistic regression analysis were used to determine the influencing factors of STR<50%. Results: 180 min after PCI, there were 147 patients with STR≥50%, 31 patients with STR<50%;The serum 25-(OH)D3, serum creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and the level of troponin (cTnT) of group B was significantly higher than that of group A ( P <0.05). The left ventricular ejection fraction (LVEF) of group B was significantly lower than that of group A, and the left ventricular end-diastolic diameter (LVEDD) was significantly higher than group A ( P <0.05);Logistic analysis showed that serum 25-(OH)D3 content was an independent risk factor for STR failure;The receiver operating curve (ROC) analysis showed that both the sensitive(82.9%) and specificity (72.3%) of serum 25-(OH)D3 content to STR deficiency were higher. Conclusion: Serum 25-(OH)D3 level is an independent risk factor for STR dysplasia after PCI in STEMI patients. It has high sensitivity and specificity for STR dysfunc- tion and can be used as an evaluation index for STR dysplasia in STEMI patients.