血清sICAM-1、IMA、Hcy检测对AMI患者PCI术后心肌低灌注的预测价值

Predictive value of sICAM-1,IMA and Hcy in myocardial hypoperfusion after PCI in AMI patients

目的探讨血清可溶性细胞间黏附分子-1(sICAM-1)、急性缺血修饰蛋白(IMA)、同型半胱氨酸(Hcy)检测对急性心肌梗死(AMI)患者行经皮冠状动脉介入治疗(PCI)术后发生心肌低灌注的预测价值。方法选取2021年1-12月西安高新医院收治并进行PCI治疗的180例AMI患者作为观察组,按照术后冠状动脉造影检查的血流分级结果分为正常灌注组(n=120)和低灌注组(n=60)。另选取同期在该院体检的健康体检者100例作为对照组。比较血清sICAM-1、IMA、Hcy在各组间的水平,采用受试者工作特征曲线分析血清sICAM-1、IMA、Hcy对AMI患者PCI术后心肌低灌注的预测价值,采用多因素Logistic回归分析AMI患者PCI术后发生心肌低灌注的危险因素。结果观察组血清sICAM-1、IMA、Hcy水平均显著高于对照组(P<0.05)。低灌注组患者血清sICAM-1、IMA、Hcy水平均明显高于正常灌注组(P<0.05)。血清sICAM-1、IMA、Hcy联合检测诊断心肌低灌注的曲线下面积为0.856,灵敏度和特异度可达到80.5%、75.0%,具有较高的诊断价值。多因素Logistic回归分析结果显示,在校正年龄因素后,血清sICAM-1、IMA、Hcy水平升高是AMI患者PCI术后发生心肌低灌注的独立危险因素(P<0.05)。结论血清sICAM-1、IMA、Hcy在AMI患者PCI术后心肌低灌注患者中明显升高,是其独立危险因素和预测因子。

Objective To investigate the predictive value of soluble intercellular adhesion molecule-1(sICAM-1),acute ischemic modified protein(IMA)and homocysteine(Hcy)in myocardial hypoperfusion after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods 180 AMI patients,who were admitted and treated by PCI in Xi′an High-tech Hospital from January to December 2021,were selected as the observation group,which were divided into the normal perfusion group(n=120)and the hypoperfusion group(n=60)according to the blood grade of postoperative coronary angiography.While a total of 100 healthy subjects,who took physical examination in the hospital during the same period,were selected as the control group.The expressions of sICAM-1,IMA and Hcy in each group were compared,and the predictive value of sICAM-1,IMA and Hcy in AMI patients with myocardial hypoperfusion after PCI was analyzed by receiver operating curve.Multivariate Logistic regression model was used to analyze the independent risk factors of myocardial hypoperfusion in AMI patients after PCI.Results The levels of sICAM-1,IMA and Hcy in the observation group were significantly higher than those in the control group(P<0.05).The levels of sICAM-1,IMA and Hcy in the hypoperfusion group were significantly higher than those in the normal perfusion group(P<0.05).The area under curve of combined detection of sICAM-1,IMA and Hcy for predicting myocardial hypoperfusion in AMI patients after PCI was 0.856,and the sensitivity and specificity reached 80.5%and 75.0%,respectively,showing high predictive value.Multivariate Logistic regression model analysis showed that after adjusting for age,increased sICAM-1,IMA and Hcy levels were independent risk factors for myocardial hypoperfusion after PCI in AMI patients.Conclusion sICAM-1,IMA,and Hcy are significantly increased in patients with AMI after PCI,and they are independent risk factors and predictors.