血清S100A4水平与急性心肌梗死患者预后相关性分析

Correlation analysis between serum S100A4 level and prognosis in patients with acute myocardial infarction

目的探讨血清钙卫蛋白A4(S100A4)水平对急性心肌梗死(AMI)患者预后的预测价值。方法选取中铁二局集团中心医院2015年6月至2018年6月诊治的128例AMI患者作为研究组,根据患者住院期间和出院后30d主要心血管不良事件(MACE)发生情况分为非MACE组(37例)和MACE组(91例);同时选取64例体检健康人群作为对照组。检测研究对象血清S100A4、B型脑钠肽(BNP)和心肌肌钙蛋白T(cTnT)水平。采用多因素Logistic回归分析MACE发生的危险因素,同时采用受试者工作特征曲线(ROC曲线)分析血清S100A4、BNP和cTnT对AMI患者发生MACE的预测价值。结果非MACE组血清S100A4、BNP和cTnT水平显著性低于MACE组(P<0.05)。受试者工作特征曲线分析显示:S100A4对AMI患者预后的预测价值优于BNP和cTnT。多因素Logistic回归分析显示:年龄(OR=2.90,95%CI 1.24~6.74)、Killip分级(OR=5.02,95%CI 2.53~9.94)、吸烟史(OR=1.67,95%CI 1.07~2.61)、BNP>389.17pg/mL(OR=1.76,95%CI 1.19~2.61)、cTnT>0.93ng/mL(OR=1.61,95%CI 1.05~2.49)、S100A4>120.56pg/mL(OR=1.88,95%CI 1.16~3.02)是AMI患者发生MACE的危险因素。结论 AMI患者血清S100A4水平显著上升,可作为预测AMI患者MACE发生的标志物。

Objective To explore the predictive value of serum calprotectin A4(S100 A4)level in the prognosis of patients with acute myocardial infarction(AMI).Methods A total of 128 patients with AMI diagnosed and treated in the Central Railway Hospital of China Railway Second Bureau Group from June 2015 to June 2018 were selected as the study group.According to the occurrence of major cardiovascular adverse events(MACE)during hospitalization and 30 dafter discharge,patients were divided into non-MACE Group(37 cases)and MACE group(91 cases);64 healthy people were selected as control group.Serum S100 A4,B-type brain natriuretic peptide(BNP)and cardiac troponin T(cTnT)levels were measured.Multivariate Logistic regression was used to analyze the risk factors of MACE,and the receiver operating characteristic curve(ROC curve)was used to analyze the predictive value of serum S100 A4,BNP and cTnT on the occurrence of MACE in AMI patients.Results The levels of serum S100 A4,BNP and cTnT in the non-MACE group were significantly lower than those in the MACE group(P<0.05).ROC curve analysis showed that S100 A4 was better than BNP and cTnT in predicting the prognosis of AMI patients.Multivariate Logistic regression analysis showed:age(OR=2.90,95%CI 1.24-6.74),Killip′s scale(OR=5.02,95%CI 2.53-9.94),smoking history(OR=1.67,95%CI 1.07-2.61),BNP>389.17 pg/mL(OR=1.76,95%CI 1.19-2.61),cTnT>0.93 ng/mL(OR=1.61,95%CI 1.05-2.49),S100 A4>120.56 pg/mL(OR=1.88,95%CI 1.16-3.02)were a risk factor for MACE in AMI patients.Conclusion The serum S100 A4 level in patients with AMI significantly increased,which can be used as a marker to predict the occurrence of MACE in AMI patients.