血浆sST2和NGAL水平对急性ST段抬高型心肌梗死患者预后的评估价值

Prognostic value of plasma levels of sST2 and NGAL in patients with ST-segment elevation myocardial infarction

目的:探讨血浆可溶性致癌抑制因子2(sST2)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平对急性ST段抬高型心肌梗死(STEMI)患者预后的评估价值。方法:选择2018-01-2019-01期间在我科住院的STEMI患者,出院后随访12个月,根据是否发生主要不良心血管事件(MACE)分为无MACE组和MACE组,检测两组的血浆sST2和NGAL水平并进行比较,分析患者发生MACE的危险因素,进行受试者工作特征(ROC)曲线分析,探讨sST2、NGAL预测患者发生MACE的最佳界值。结果:MACE组的sST2、NGAL水平明显高于无MACE组(P<0.05),差异有统计学意义;ROC曲线分析显示,sST2预测发生MACE的曲线下面积为0.897(P<0.05),NGAL预测发生MACE的曲线下面积为0.647(P<0.05)。多因素Logistic回归分析表明,sST2、NGAL与MACE发生具有明显相关性(P<0.05)。结论:血浆sST2、NGAL水平对STEMI患者的预后评估具有非常重要的临床意义。

Objective:To investigate the prognostic value of plasma levels of sST2 and NGAL in patients with ST-segment elevation myocardial infarction(STEMI).Method:The STEMI patients were selected in the affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from Jan 2018 to Jan 2019 and divided into non-MACE group and MACE group according to MACE occurrence or not during follow-up of 12 months.The plasma levels of soluble suppression of tumorigenicity-2(sST2)and neutrophil gelatinase-associated lipocalin(NGAL)were compared between the two groups.The risk factors of MACE occurrence in STEMI patients were analyzed.Receiver operator characteristic(ROC)curve was performed to find the optimal cutoff point for predicting MACE occurrence in these participants.Result:The plasma levels of sST2 and NGAL were increased dramatically in MACE group compared with non-MACE group(P<0.05).Meanwhile,ROC curve of sST2 and NGAL predicting MACE occurrence showed that the area under curve were 0.897 and 0.647(P<0.05),respectively.Multivariate logistic regression analysis showed that the levels of sST2 and NGAL were independently associated with MACE occurrence(P<0.05).Conclusion:The plasma levels of sST2 and NGAL are of great clinical significance for the prognosis of STEMI patients.