急性心肌梗死PCI术后患者的血清NT-proBNP、ICTP、MMP-9水平及其临床意义研究

Predictive value of early detection of serum NT-proBNP,ICTP and MMP-9 levels in patients with acute myocardial infarction after PCI

目的分析急性心肌梗死PCI术后患者的血清NT-proBNP、ICTP、MMP-9水平,并分析其临床意义。方法选取2016年2月至2018年8月因急性心肌梗死在本院行PCI手术的300例患者为研究对象,根据术后是否发生心血管不良事件分为发生组和未发生组。比较不同临床特征患者心血管不良事件发生率的差异,分析影响心血管不良事件发生的危险因素。结果300例急性心肌梗死PCI术后患者发生心血管不良事件的例数为40例,心血管不良事件发生率为13.33%;BMI≥24 kg/m2、合并高脂血症、置入支架数目≥2个、支架直径≥3 mm的急性心肌梗死PCI术后患者发生心血管不良事件发生率较高,发生心血管不良事件的患者NT-proBNP较高、MMP-9水平较低,不同年龄、性别、饮酒史、吸烟史、糖尿病史、卒中史、ICTP水平的患者心血管不良事件发生率差别无统计学意义;将单因素分析有统计学差异的因素作为自变量,将是否发生血栓作为因变量,进行多因素Logistic回归分析,结果显示置入支架数目和MMP-9水平的OR值分别为5.204和4.342。结论置入支架数目和MMP-9水平是影响急性心肌梗死PCI术后患者心血管不良事件发生的独立危险因素,提示临床应早期监测血清MMP-9等指标。

Objective To analyze the serum levels of NT⁃proBNP,ICTP and MMP⁃9 in patients with acute myocardial infarction after PCI,and to analyze its clinical significance.Methods Patients who underwent PCI in our hospital from February 2016 to August 2018 due to acute myocardial infarction were enrolled in the study.According to whether there were cardiovascular adverse events after operation,they were divided into the occurrence group and the non⁃occurring group.To compare the differences in the incidence of cardiovascular adverse events in patients with different clinical characteristics,and to analyze the risk factors affecting the occurrence of cardiovascular adverse events.Results The number of cardiovascular adverse events in 300 patients with acute myocardial infarction was 40,and the incidence of cardiovascular adverse events was 13.33%.BMI≥24 kg/m2,hyperlipidemia,and number of stents≥2 The incidence of cardiovascular adverse events was higher in patients with acute myocardial infarction with stent diameter≥3 mm.Patients with cardiovascular adverse events had higher NT⁃proBNP and lower MMP⁃9 levels,different ages,genders,and alcohol consumption.There was no statistically significant difference in the incidence of cardiovascular adverse events among patients with medical history,smoking history,diabetes history,stroke history,and ICTP level;factors with statistical differences in univariate analysis were used as independent variables,and the occurrence of thrombus was used as the dependent variable.Multivariate Logistic regression analysis showed that the OR values of the number of stent placement and MMP⁃9 levels were 5.204 and 4.342,respectively.Conclusion The number of stents and MMP⁃9 levels are independent risk factors for cardiovascular adverse events in patients with acute myocardial infarction after PCI,suggesting that serum MMP⁃9 should be monitored early in the clinic.