急性心肌梗死患者经皮冠状动脉介入术后血清成纤维细胞生长因子21和髓过氧化物酶水平与预后的关系

Relationship between the levels of serum fibroblast growth factor-21 and myeloperoxidase and prognosis in patients with acute myocardial infarction after percutaneous coronary intervention

目的探究急性心肌梗死(AMI)患者经皮冠状动脉介入术(PCI)后血清成纤维细胞生长因子21(FGF-21)、髓过氧化物酶(MPO)水平与预后的关系。方法选择2016年1月至2018年12月在我院接受PCI术治疗的108例AMI患者作为研究对象。根据随访过程中是否发生主要不良心血管事件(MACE),病人分为预后不良组(25例)和预后良好组(83例)。采用酶联免疫吸附法检测受试者血清FGF-21水平,采用胶体金免疫层析法检测受试者血清MPO水平。分析FGF-21、MPO与AMI患者PCI术后MACE发生的关系及诊断MACE发生的效能。结果预后不良组血清FGF-21、MPO水平均高于预后良好组,差异均有统计学意义(P<0.05)。FGF-21+MPO诊断AMI患者PCI术后MACE发生的ROC曲线下面积(AUC)为0.860,高于FGF-21、MPO单独诊断AMI患者PCI术后MACE发生的AUC。FGF-21>140.41 ng/L和FGF-21≤140.41 ng/L的患者,MACE发生率分别为39.58%和10.00%,差异有统计学意义(P<0.001)。MPO>419.42μg/L和MPO≤419.42μg/L的患者,MACE发生率分别为35.00%和8.33%,差异有统计学意义(P=0.001)。Cox单因素及Cox多因素分析显示FGF-21、MPO与AMI患者PCI术后MACE发生密切相关(均P<0.05)。结论 AMI患者PCI术后血清FGF-21、MPO水平与预后有关。高水平的FGF-21、MPO与MACE发生密切相关。

Aim To investigate the relationship between serum fibroblast growth factor-21( FGF-21),myeloperoxidase( MPO) levels and prognosis in patients with acute myocardial infarction( AMI) after percutaneous coronary intervention( PCI). Methods 108 AMI patients who received PCI in our hospital from January 2016 to December 2018 were selected as the study subjects. According to whether major adverse cardiovascular events( MACE) occurred during follow-up,patients were divided into two groups: poor prognosis group( 25 cases) and good prognosis group( 83 cases).The levels of serum FGF-21 and MPO were detected by enzyme-linked immunosorbent assay and colloidal gold immunochromatography respectively. The relationship between FGF-21,MPO and MACE in AMI patients after PCI,and the efficacy of FGF-21,MPO in the diagnosis of MACE were analyzed. Results The levels of serum FGF-21 and MPO in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant( P<0. 05). Area under ROC curve( AUC) of FGF-21 + MPO in the diagnosis of MACE in AMI patients after PCI was0. 860,which was higher than that of FGF-21 and MPO alone in the diagnosis of MACE in AMI patients after PCI. In pa-tients with FGF-21>140. 41 ng/L and FGF-21≤140. 41 ng/L,the incidence of MACE was 39. 58% and 10. 00%,respectively,and the difference was statistically significant( P < 0. 001). In patients with MPO > 419. 42 μg/L and MPO ≤419. 42 μg/L,the incidence of MACE was 35. 00% and 8. 33%,respectively,and the difference was statistically significant( P = 0. 001). Cox univariate and multivariate analysis showed that FGF-21 and MPO were closely related to MACE in AMI patients after PCI( all P<0. 05). Conclusion The levels of serum FGF-21 and MPO are related to the prognosis in AMI patients after PCI,and high levels of serum FGF-21 and MPO are closely related to MACE.