血清sST2蛋白预测急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后心力衰竭的临床研究

Clinical study on serum sST2 protein in predicting heart failure in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention

目的探究与分析血清可溶性致癌抑制因子-2(sST2)蛋白预测急性ST段抬高型心肌梗死患者经皮冠状动脉介入(PCI)治疗后心力衰竭的价值。方法回顾性分析,选取2019年6月至2021年1月滨州市中心医院收治急性ST段抬高型心肌梗死患者110例的临床资料,所有患者均接受PCI治疗,对比患者在入院时、术后即刻的血清sST2蛋白水平,同时根据PCI术后半年内患者是否出现心力衰竭分为心力衰竭组(29例)及非心力衰竭组(81例),对比两组患者的血清sST2蛋白水平,先采用单因素分析,之后采用logistic回归分析对影响PCI治疗后发生心力衰竭的高危因素进行分析。计数资料采用χ^(2)检验,计量资料采用t检验。结果110例急性ST段抬高型心肌梗死患者术后即刻血清sST2蛋白水平为(73.35±20.69)μg/L,明显高于入院时(51.24±12.58)μg/L,差异有统计学意义(t=9.577,P<0.001)。行多因素logistic分析可见,影响急性ST段抬高型心肌梗死经PCI后发生心力衰竭的高危因素包括年龄较高、多个部位梗死、病变支数≥2支、左心室射血分数(LVEF)<50%、发病至PCI的时间≥12 h、PCI后即刻血清sST2蛋白水平、PCI治疗后慢复流或无复流(均P<0.05)。结论急性ST段抬高型心肌梗死患者经PCI后即刻可出现血清sST2蛋白水平升高的表现,同时血清sST2蛋白水平在术后合并心力衰竭的患者中表现出了较高的水平,且年龄较高、多个部位梗死、病变支数≥2支、LVEF<50%、发病至PCI的时间≥12 h、PCI后即刻血清sST2蛋白水平、PCI治疗后慢复流或无复流均可作为影响急性ST段抬高型心肌梗死患者PCI治疗后心力衰竭的高危因素。

Objective To explore and analyze the clinical value of serum soluble suppression of tumorigenicity 2(sST2)protein in predicting heart failure in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention(PCI)treatment.Methods The clinical data of 110 patients with acute ST-segment elevation myocardial infarction treated in Binzhou Central Hospital from June 2019 to January 2021 were selected for the retrospective analysis,and all the patients received PCI.The serum sST2 protein levels at the time of admission and immediately after surgery were compared.At the same time all the patients were divided into a heart failure group(29 cases)and a non-heart failure group(81 cases)according to whether the patients developed heart failure within 6 months after PCI,and the serum sST2 protein levels of the two groups were compared.Single factor analysis was used firstly,and then logistic regression analysis was used to analyze the high-risk factors affecting heart failure after PCI.χ^(2) test was used for the count data and t test was used for the measurement data.Results The serum sST2 protein level in the 110 patients immediately after surgery was significantly higher than that at the time of admission[(73.35±20.69)μg/L vs.(51.24±12.58)μg/L],with a statistically significant difference(t=9.577,P<0.001).According to the multivariate logistic analysis,the high-risk factors for heart failure in patients with acute ST-segment elevation myocardial infarction after PCI included older age,multiple site infarction,number of lesions≥2,left ventricular ejection fraction(LVEF)<50%,time from onset to PCI≥12 h,serum sST2 protein level immediately after PCI,and slow or no reflow after PCI(all P<0.05).Conclusions The patients with acute ST-segment elevation myocardial infarction may have elevated serum sST2 protein level immediately after PCI.At the same time,the serum sST2 protein level is higher in patients with postoperative heart failure.Older age,multiple site infarction,number of lesions≥2,LVEF<50%,time from onset to PCI≥12 h,serum sST2 protein level immediately after PCI,and slow or no reflow after PCI can all be considered as the high-risk factors affecting heart failure in patients with acute ST segment elevation myocardial infarction after PCI.