急性ST段抬高型心肌梗死介入手术时间窗与血清FGF-21水平的相关性

Correlation between the Time Window of Interventional Surgery and Serum FGF-21 Level in Acute ST-segment Elevation Myocardial Infarction

目的:探究急性ST段抬高型心肌梗死介入手术时间窗与血清FGF-21水平的相关性。方法:选取2019年3月-2021年5月在我院接受PPCI手术并住院治疗且符合STEMI诊断标准的73例患者,根据FGF-21水平高低,将73例患者分为FGF-21低水平组(>140.41 ng/L,n=54例)和FGF-21高水平组(<140.41 ng/L,n=19例)。对比分析两组患者的一般临床资料、急救时间窗和SO-to-FMC时间差异,再通过Spearson法判断急救时间窗与FGF-21水平的相关性。结果:FGF-21低水平组患者的急救时间窗SO-to-FMC、FMC-to-B、D2B和STB均较FGF-21高水平组患者时间长,且SO-to-FMC时间>120 min是导致FGF-21水平变低的危险因素,介入手术时间窗指标与FGF-21水平均呈正相关(r=0.235、0.462、0.298、0.337)。高血压史、糖尿病史、首次医疗接触方式(急诊)和SO-to-FMC均是FGF-21水平变化的独立危险因素,且差异有统计学意义(P<0.05)。结论:SO-to-FMC时间和STB时间延长可能促进STEMI患者FGF-21水平异常,故应严格把握好院外的急救时间。

Objective: To investigate the correlation between the time window of interventional surgery and serum FGF-21 level in acute ST-segment elevation myocardial infarction. Methods: Seventy-three patients who received PPCI surgery and were hospitalized in our hospital from March 2019 to May 2021 and met STEMI diagnostic criteria were selected. According to the level of FGF-21, the 73 patients were divided into FGF-21 low level group(>140.41 ng/L, n=54) and FGF-21 high level group(<140.41 ng/L, n=19). The differences in general clinical data, emergency time window and SO-to-FMC time between the two groups were compared and analyzed, and the correlation between emergency time window and FGF-21 level was determined by Spearson method. Results: The emergency time window of SO-to-FMC, FMC-to-B, D2 B and STB in patients with low FGF-21 level was longer than those in patients with high FGF-21 level, and >120 min in SO-to-FMC was a risk factor leading to low FGF-21 level. There was a positive correlation between FGF-21 level and the time indicators of first aid time window(r=0.235, 0.462, 0.298, 0.337). History of hypertension, history of diabetes, first medical contact(emergency) and SO-to-FMC were all independent risk factors for the change of FGF-21 level, and the difference was statistically significant(P<0.05). Conclusion: Prolonged SO-to-FMC time and STB time may promote abnormal FGF-21 level in STEMI patients, SO the time of emergency treatment outside the hospital should be strictly controlled.