血清H-FABP、MAGE与CK-MB水平监测对急性心肌梗死患者经PCI治疗预后的影响

Influence of monitoring serum H-FABP, MAGE and CK-MB level on prognosis of patients with acute myocardial infarction after PCI

目的 探讨血清心脏型脂肪酸结合蛋白(heart fatty-acid-binding protein, H-FABP)、平均血糖波动幅度(mean amplitude of glycemic excursions, MAGE)与肌酸激酶同工酶(creatine kinase isoenzyme, CK-MB)水平监测对急性心肌梗死患者经皮冠状动脉介入(PCI)治疗预后的影响。方法 选取2016年6月至2019年9月河南省民权县中医院住院部进行PCI术治疗的106例急性心肌梗死患者设为观察组,选取同期进行体检的110例健康者,设为对照组。对比不同人群CK-MB、H-FABP、MAGE水平,分析三者对PCI术后预后不良的预测价值及影响患者预后的相关危险因素。结果 观察组CK-MB、H-FABP、MAGE水平明显高于对照组,差异有统计学意义(P<0.05);预后不良组CK-MB、H-FABP、MAGE水平明显高于预后良好组,差异有统计学意义(P<0.05);年龄、高血压史、糖尿病史、心脑血管家族遗传史、吸烟史、CK-MB (异常升高)、H-FABP(异常升高)、MAGE(异常升高)为影响急性心肌梗死患者PCI术后预后不良的相关危险因素(P<0.05);CK-MB、H-FABP、MAGE及三者联合检测曲线下面积(AUC)分别为0.741、0.894、0.894、0.960,各指标AUC以联合检测最大。结论 CK-MB、H-FABP、MAGE水平在进行PCI术治疗的急性心肌梗死预后不良的患者中呈异常升高表达状态,与患者预后不良有关。

【Objective】To explore the effects of monitoring serum heart fatty-acid-binding protein(H-FABP), mean amplitude of glycemic excursions(MAGE) and creatine kinase isoenzyme(CK-MB) on the prognosis of patients with acute myocardial infarction after percutaneous coronary intervention(PCI). 【Methods】The 106 patients with acute myocardial infarction who underwent PCI in the inpatient department of our hospital from June 2016 to September 2019 were selected as the observation group, and 110 healthy patients who underwent physical examination in our hospital during the same period were selected as the control group. The levels of CK-MB, H-FABP and MAGE in different people were compared. The predictive value of the three indicators for poor prognosis after PCI and related risk factors affecting the prognosis of patients were analyzed. 【Results】(1) The levels of CK-MB, H-FABP and MAGE in the observation group were significantly higher than those in the control group, and the difference was statistically significant(P<0.05).(2) The levels of CK-MB, H-FABP and MAGE in the poor prognosis group were significantly higher than those in the good prognosis group, and the difference was statistically significant(P<0.05).(3) Age, history of hypertension, history of diabetes, cardiovascular and cerebrovascular genetic history of family, history of smoking, CK-MB(abnormal increase), H-FABP(abnormal increase), MAGE(abnormal increase) are related risk factors that affect the poor prognosis of patients with acute myocardial infarction after PCI(P<0.05).(4) The AUC of CK-MB, H-FABP, MAGE and the combined detection of them were 0.741, 0.894, 0.894, 0.960, respectively, and the AUC of the combined detection was the largest.【Conclusion】The levels of CK-MB, H-FABP, and MAGE are abnormally increased in patients with poor prognosis of acute myocardial infarction treated by PCI, which are related to the poor prognosis of patients.