降钙素原与急性心肌梗死患者冠脉病变程度及不良心血管事件的相关性分析

Correlation Analysis of Procalcitonin with Coronary Artery Lesions and Adverse Cardiovascular Events in Patients with Acute Myocardial infarction

目的:探讨降钙素原(PCT)与急性心肌梗死(AMI)患者冠脉病变程度和住院期间不良心血管事件的相关性。方法:选取2020年6月-2021年12月东海县人民医院心内科收治的AMI患者112例为研究对象。检测患者血清PCT的峰值浓度,依据PCT水平将AMI患者分为低PCT组(PCT≤0.25 ng/mL)和高PCT组(PCT>0.25 ng/mL);依冠状动脉受累的支数将心肌梗死组分为单支、双支和多支组;依是否发生心血管事件分为心血管事件组和非心血管事件组;患者冠脉病变严重程度通过Gensini积分计算获得。比较不同冠脉病变支数心肌标志物和炎性因子水平,不同PCT水平组间冠脉病变程度,血清PCT水平与心血管事件的关系,心血管事件影响因素的logistic逐步回归分析。结果:多支病变组肌酸激酶同工酶、肌钙蛋白(hs-cTnT)、hs-CRP、PCT水平高于双支病变组、单支病变组,差异有统计学意义(P<0.05);低PCT组单支血管病变率高于高PCT组,高PCT组多支血管病变率高于低PCT组,差异有统计学意义(P<0.05);高PCT组Gensini积分高于低PCT组,差异有统计学意义(P<0.05);心血管事件组PCT水平、PCT异常率高于非心血管事件组,差异有统计学意义(P<0.05);在排除多种因素的交互影响后,hs-cTnT、PCT、Gensini积分对AMI患者的近期预后有一定的预测价值(P<0.05)。结论:PCT与AMI患者的冠脉病变程度密切相关,对AMI患者住院期间不良心血管事件的发生有一定的预测价值。

Objective:To investigate the correlation between procalcitonin(PCT)and the degree of coronary artery lesions and adverse cardiovascular events during hospitalization in patients with acute myocardial infarction(AMI).Methods:One hundred and twelve patients with AMI admitted to the Department of Cardiology of Donghai County People's Hospital from June 2020 to December 2021 were selected as subjects.The peak concentration of serum PCT was detected.AMI patients were divided into low PCT group(PCT≤0.25 ng/mL)and high PCT group(PCT>0.25 ng/mL)according to the level of PCT.According to the number of involved coronary arteries,the myocardial infarction group was divided into single,double and multi-branch groups.They were divided into cardiovascular event group and non-cardiovascular event group according to the occurrence of cardiovascular event.The severity of patients'coronary lesions was calculated by Gensini integral.The levels of myocardial markers and inflammatory factors of different coronary artery disease counts,the degree of coronary artery disease among different PCT levels,the relationship between serum PCT level and cardiovascular events,and the logistic stepwise regression analysis of influencing factors of cardiovascular events.Results:The levels of creatine kinase isoenzyme,troponin(hs-cTnT),hs-CRP and PCT in multibranch disease group were higher than those in double-branch disease group and single-branch disease group,and the difference was statistically significant(P<0.05).The rate of single-vessel lesions in low PCT group was higher than that in high PCT group,and the rate of multi-vessel lesions in high PCT group was higher than that in low PCT group,and the difference was statistically significant(P<0.05).The Gensini score of the high PCT group was higher than that of the low PCT group,and the difference was statistically significant(P<0.05).The level of PCT and abnormal rate of PCT in cardiovascular event group were higher than those in non-cardiovascular event group,and the difference was statistically significant(P<0.05).After excluding the interaction of various factors,hs-cTnT,PCT and Gensini scores had certain predictive value for the short-term prognosis of AMI patients(P<0.05).Conclusion:PCT is closely related to the degree of coronary artery lesions in patients with AMI,and has certain predictive value for the occurrence of adverse cardiovascular events in patients with AMI during hospitalization.