PCI术后患者血清EPO、VEGF、CA125水平变化及患者预后的影响因素分析

Changes of serum EPO,VEGF and CA125 levels and the influencing factors of prognosis of patients after PCI

目的探究经皮冠状动脉介入(PCI)术后患者血清促红细胞生成素(EPO)、血管内皮生长因子(VEGF)、糖类蛋白125(CA125)水平变化及患者预后的影响因素。方法回顾性分析123例急性心肌梗死PCI术后患者的一般资料及血清EPO、VEGF、CA125水平变化,根据患者30 d内是否发生主要不良心血管事件(MACE)将其分为预后良好组(101例)和预后不良组(22例)。比较两组的血清EPO、VEGF、CA125水平变化及一般资料,通过多因素Logistic回归分析法分析PCI术后患者预后不良的危险因素。结果123例急性心肌梗死患者PCI术后30 d内发生MACE的有22例,发生率为17.89%(22/123)。多因素Logistic回归分析法结果显示,非单支病变,Killip分级>Ⅱ级及EPO、VEGF、CA125水平升高均为急性心肌梗死患者PCI术后预后不良的危险因素(OR=2.100、3.435、1.906、2.077、3.747,P<0.05)。结论急性心肌梗死PCI术后预后不良患者血清EPO、VEGF、CA125水平升高,可作为临床诊治的靶因子,而非单支病变,Killip分级>Ⅱ级及EPO、VEGF、CA125水平升高为患者预后不良的危险因素,临床可根据以上指标给予针对性干预,进而改善其预后。

Objective To investigate the changes of serum levels of erythropoietin(EPO),vascular endothelial growth factor(VEGF),glycoprotein 125(CA125)and the influencing factors of prognosis in patients after percutaneous coronary intervention(PCI).Methods The general data and changes of EPO,VEGF and CA125 levels in totally 123 patients with acute myocardial infarction after PCI were retrospectively analyzed.According to whether major adverse cardiovascular events(MACE)occurred within 30 days,the patients were divided into good prognosis group(101 cases)and poor prognosis group(22 cases).The changes of serum EPO,VEGF and CA125 levels and general data of the two groups were compared,and the risk factors for poor prognosis of patients after PCI were analyzed by multivariate Logistic regression analysis.Results MACE occurred in 22 of 123 patients with acute myocardial infarction within 30 days after PCI,and the incidence rate was 17.89%(22/123).Multivariate Logistic regression analysis showed that no single-vessel lesions,Killip grade>Ⅱ,elevated levels of EPO,VEGF and CA125 were all risk factors for poor prognosis in patients with acute myocardial infarction after PCI(OR=2.100,3.435,1.906,2.077,3.747,P<0.05).Conclusion Elevated levels of EPO,VEGF and CA125 in patients with poor prognosis after PCI could be used as the target factors for clinical diagnosis and treatment,while no single-vessel lesions,Killip grade>Ⅱand elevated levels of EPO,VEGF and CA125 are risk factors for poor prognosis.Clinical intervention could be given according to the above indicators to improve the prognosis.