血清纤维胶凝蛋白-3浓度与老年急性心肌梗死患者心肌损伤及预后的关系

Correlations between serum concentration of ficolin-3 with myocardial injury and prognosis in elderly patients with acute myocardial infarction

目的 探究老年急性心肌梗死(acute myocardial infarction,AMI)患者血清纤维胶凝蛋白-3浓度与心肌损伤及预后的相关性。方法 选取2018年12月至2020年10月彭州市人民医院收治的老年AMI患者128例为观察组,所有患者入院24 h内均接受经皮冠状动脉介入治疗,同期选择本院体检健康老年人128名为对照组。采用酶联免疫吸附法测定两组血清纤维胶凝蛋白-3浓度;采用微粒子酶免疫分析法检测血清心肌肌钙蛋白Ⅰ(cardiac troponin I,cTnI)、肌酸激酶同工酶(creatine kinase isoenzyme-MB,CK-MB)、肌红蛋白(myoglobin,Myo)浓度。分析纤维胶凝蛋白-3浓度与cTnI、CK-MB、Myo浓度的相关性;分析纤维胶凝蛋白-3浓度与术后3个月主要不良心血管事件发生的关系。Logistic回归分析分析影响老年AMI患者预后的因素。结果 与对照组相比,观察组患者血清纤维胶凝蛋白-3[(16.74±4.95)μg/L vs.(26.58±5.53)μg/L]浓度较低(P<0.05),cTnI[(4.27±1.02)μg/L vs.(0.08±0.02)μg/L]、Myo[(62.73±6.39)μg/L vs.(31.48±4.62)μg/L]、CK-MB[(12.06±1.87)μg/L vs.(4.96±0.58)μg/L]浓度较高(P<0.05),差异有统计学意义。Pearson分析结果显示,观察组患者血清纤维胶凝蛋白-3浓度与cTnI、Myo、CK-MB浓度呈负相关(r=-0.470,P<0.001;r=-0.536,P<0.001;r=-0.534,P<0.001)。随访老年AMI患者3个月发现,纤维胶凝蛋白-3低浓度组患者主要不良心血管事件发生率(51.02%)显著高于纤维胶凝蛋白-3高浓度组(16.46%),差异有统计学意义(χ^(2)=17.309,P<0.001)。Logistic回归分析显示,低浓度纤维胶凝蛋白-3是老年AMI患者预后不良的危险因素(P<0.05)。结论 老年AMI患者血清中纤维胶凝蛋白-3浓度下调,纤维胶凝蛋白-3与心肌损伤标志物浓度呈负相关,是不良预后的危险因素,为临床预测AMI患者经皮冠状动脉介入治疗后主要不良心血管事件提供一定参考依据。

Objectives To explore the correlations between serum concentration of ficolin-3 with myocardial injury and prognosis in elderly patients with acute myocardial infarction(AMI). Methods From December 2018 to October 2020,128 elderly AMI patients hospitalized in Pengzhou People′s Hospital were selected as observation group,who were treated with percutaneous coronary intervention(PCI) within 24 hours after admission. Meanwhile,128 healthy elderly people in our hospital were selected as control group. The serum concentration of ficolin-3 was measured by enzyme-linked immunosorbent assay;the serum concentrations of cardiac troponin I(cTnI),creatine kinase isoenzyme(CK-MB)and myoglobin(Myo)were detected by microparticle enzyme immunoassay. The correlations between serum concentrations of ficolin-3 and cTnI,CK-MB,Myo were analyzed;and the relationship between the serum concentration of ficolin-3 and the cardiovascular adverse events 3 months after operation was analyzed. Prognostic factors on elderly patients with AMI was analyzed by Logistic regression analysis. Results Compared with control group,the serum concentration of ficolin-3[(16.74±4.95)μg/L vs.(26.58±5.53)μg/L]in observation group was lower(P<0.05);while the serum concentrations of c TnI[(4.27±1.02)μg/L vs.(0.08±0.02)μg/L],Myo[(62.73±6.39)μg/L vs.(31.48±4.62)μg/L]and CK-MB[(12.06±1.87)μg/L vs.(4.96±0.58)μg/L]were significantly higher(P<0.05). Pearson analysis showed that serum concentration of ficolin-3 negatively correlated with serum concentrations of cTnI,Myo and CK-MB(r=-0.470,P<0.001;r=-0.536,P<0.001;r=-0.534,P<0.001). The 3-month follow-up result of elderly AMI patients showed that the incidence of cardiovascular adverse events in low serum concentration of ficolin-3 group(51.02%)was significantly higher than that in high serum concentration of Ficolin-3 group(16.46%)(χ^(2)= 17.309,P<0.001). Logistic regression analysis showed that low serum concentration of Ficolin-3 was a risk factor for poor prognosis in elderly patients with AMI(P<0.05). Conclusions The serum concentration of ficolin-3 in elderly patients with AMI is downregulated,and ficolin-3 negatively correlates with the concentrations of myocardial injury markers,which is a risk factor for adverse prognosis,can provide a certain reference for clinical prediction of cardiovascular adverse events in patients with AMI after PCI.