AMI患者PCI术后血清MPO、INTβ1、VEGF水平及其预后价值

Serum MPO,INTβ1,VEGF levels and their prognostic value in AMI patients after PCI

目的:探讨髓过氧化物酶(MPO)、整合素β1(INTβ1)、血管内皮生长因子(VEGF)在急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后的水平及其对患者预后预测价值。方法:选择本院收治的255例行PCI术治疗的AMI患者为研究对象。所有受试者术后随访1年,失访9例。根据随访期间患者是否发生主要不良心血管事件(MACE)分为预后不良组(35例)和预后良好组(211例)。比较两组血清MPO、INTβ1、VEGF水平及其他可能影响患者预后的相关因素。结果:预后不良组患者白细胞计数、C反应蛋白(CRP)、MPO、INTβ1、VEGF水平均显著高于预后良好组(P均=0.001)。Logistic二元回归分析显示血清CRP、MPO、INTβ1、VEGF水平异常均是AMI患者PCI术后发生MACE的独立危险因素(OR=2.094~2.651,P均<0.01)。ROC曲线分析显示,血清MPO、INTβ1、VEGF水平三者联合检测(AUC=0.849)预测AMI患者PCI术后发生MACE的价值要高于各指标单独检测(AUC=0.794、0.743、0.775),其灵敏度、特异度分别为78.6%、81.7%。结论:AMI患者PCI术后血清MPO、INTβ1、VEGF水平对预后具有一定预测价值。

Objective:To explore levels of myeloperoxidase(MPO),integrinβ1(INTβ1)and vascular endothelial growth factor(VEGF)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)and their predictive value for prognosis.Methods:A total of 255 AMI patients who underwent PCI and were treated in our hospital were selected.All subjects were followed up for one year after PCI,and nine cases were lost.According to occurrence of major adverse cardiovascular events(MACE)during follow-up,patients were divided into poor prognosis group(n=35)and good prognosis group(n=211).Serum levels of MPO,INTβ1,VEGF,and other factors that may affect prognosis were compared between two groups.Results:Compared with good prognosis group,there were significant rise in white blood cell count,levels of C reactive protein(CRP),MPO,INTβ1 and VEGF in poor prognosis group,P=0.001 all.Logistic binary regression analysis indicated that abnormal serum levels of CRP,MPO,INTβ1 and VEGF were independent risk factors for MACE in AMI patients after PCI(OR=2.094~2.651,P<0.01 all).ROC analysis indicated that combined detection of serum levels of MPO,INTβ1 and VEGF(AUC=0.849)possessed higher value than those of single detection(AUC=0.794,0.743,0.775)in predicting MACE in AMI patients after PCI,and its sensitivity and specificity was 78.6%and 81.7%respectively.Conclusion:Serum levels of MPO,INTβ1 and VEGF in AMI patients after PCI possess certain predictive value for prognosis.