胱抑素C、视黄醇结合蛋白对急性心肌梗死后心室重构的预测价值

Predictive Value of Cystatin C and Retinol Binding Protein in Ventricular Remodeling After Acute Myocardial Infarction

目的通过测定胱抑素C及视黄醇结合蛋白(retionl bindig protein,RBP)水平,探讨其与首发急性心肌梗死(acute myocardial infarction,AMI)后心室重构(ventricular remodeling,VRM)的关联性。方法选取2018年9月至2019年12月期间在辽阳市中心医院CCU病房发病12 h以内首次确诊急性心肌梗死患者并行PCI术患者147例。入院采血检测血清胱抑素C、视黄醇结合蛋白及其他生化指标,同时进行心脏彩超测定:包括左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左心室舒张末期容积(left ventricular end-diastolic volume,LVEDV)、左心室射血分数(left ventricular ejection fraction,LVEF),并于术后12个月复查心脏彩超等相关指标。结果(1)心室重构组患者的胱抑素C及RBP水平明显明显高于非心室重构组,差异具有统计学意义(P<0.05),血清胱抑素C及RBP的水平与冠脉病变支数的关系,多支病变组明显高于单支病变组、双支病变组,差异具有统计学意义(P<0.05);(2)血清胱抑素C及RBP水平与LVEF呈负相关、与LVEDD呈正相关,与LVEDV呈正相关。结论测定胱抑素C及RBP的水平可以判断冠状动脉病变支数及心室重构的发生,对于心肌梗死后心室重构有重要的预测价值,为临床急性心肌梗死的治疗、病情评估及相关预后提供科学依据。

Objective To investigate the correlation between Cystatin C and retionl bindig protein(RBP)and ventricular remodeling(VRM)after first-episode acute myocardial infarction(AMI)by measuring the levels of cystatin C and RBP.Methods 147 patients who were diagnosed with acute myocardial infarction within 12 h of onset for the first time and underwent PCI in CCU of Liaoyang Central Hospital from September 2018 to December 2019 were selected.Blood samples were collected in the hospital to detect serum cystatin C,RBP and other biochemical indicators.At the same time,cardiac color ultrasound was performed,including left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic volume(LVEDV)and left ventricular ejection fraction(LVEF).Cardiac color ultrasound and other relevant indicators were reexamined 12 months after surgery.Results(1)The levels of cystatin C and RBP in the ventricular remodeling group were significantly higher than those in the non-remodeling group,with statistically significant difference(P<0.05).The levels of serum cystatin C and RBP and the number of coronary artery lesions in the multi-vessel lesion group were significantly higher than those in the single-vessel lesion group and the double-vessel lesion group,with statistically significant difference(P<0.05).(2)Levels of Serum cystatin C and RBP were negatively correlated with LVEF,and positively correlated with LVEDD and LVEDV.Conclusion The measurement of cystatin C and RBP levels can be used to determine the number of coronary artery lesions and the occurrence of ventricular remodeling,with important predictive value for the ventricular remodeling after myocardial infarction,and provides a scientific basis for the treatment,disease assessment and prognosis of clinical acute myocardial infarction.