老年急性心肌梗死患者血清纤维凝胶蛋白-3、C5b-9水平与心血管不良事件相关性研究

Relationship between serum Ficolin-3,C5b-9 levels and follow-up cardiovascular adverse events in elderly patients with acute myocardial infarction

目的探讨老年急性心肌梗死(AMI)患者血清纤维凝胶蛋白-3、C5b-9水平与心血管不良事件的相关性。方法选取自2018年6月至2021年6月东营市人民医院收治的113例老年AMI患者纳入AMI组,另选取同期来我院体检的120例健康人纳入健康组。出院后连续随访1年,根据是否发生心血管不良事件将AMI组分为不良组(n=36)和良好组(n=77)。采用酶联免疫吸附法检测血清纤维凝胶蛋白-3、C5b-9水平;采用受试者工作特性(ROC)曲线评估血清纤维凝胶蛋白-3、C5b-9对老年AMI患者心血管不良事件的预测价值;采用多因素Logistic回归分析影响老年AMI患者心血管不良事件的因素。结果AMI组受试者血清纤维凝胶蛋白-3水平低于健康组,C5b-9水平高于健康组,差异有统计学意义(P<0.05)。不良组受试者血清纤维凝胶蛋白-3水平低于良好组,C5b-9水平高于良好组,差异有统计学意义(P<0.05)。血清纤维凝胶蛋白-3、C5b-9预测老年AMI患者发生心血管不良事件的曲线下面积分别为0.762、0.835,两者联合预测的AUC为0.912。多因素Logistic回归分析结果显示,Killip心功能分级为Ⅲ~Ⅳ级、纤维凝胶蛋白-3≤14.89μg/ml、C5b-9≥185.14 ng/ml是影响老年AMI患者心血管不良事件的相关因素(P<0.05)。结论老年AMI患者血清纤维凝胶蛋白-3、C5b-9与心血管不良事件的发生密切相关,两者联合检测对心血管不良事件的发生具有较高预测价值。

Objective To explore the relationship between serum Ficolin-3,C5b-9 levels and follow-up cardiovascular adverse events in elderly patients with acute myocardial infarction(AMI).Methods A total of 113 elderly patients with AMI admitted from June 2018 to June 2021 were selected as the AMI group,and 120 healthy people who came to our hospital for physical examination during the same period were selected as the health group.After discharge,the AMI group was followed up for one year continuously,and was divided into poor group(n=36)and good group(n=77)according to whether there were adverse.The levels of Ficolin-3 and C5b-9 in serum were detected by enzyme-linked immunosorbent assay.The diagnostic value of serum Ficolin-3 and C5b-9 for cardiovascular adverse events in elderly patients with AMI was evaluated by the receiver operating characteristic(ROC).The influencing factors of cardiovascular adverse events in elderly patients with AMI was explored by multivariate logistic regression.Results The serum Ficolin-3 level in the AMI group was lower than that in the healthy group,and the C5b-9 level was higher than that in the healthy group,the difference was statistically significant(P<0.05).The serum Ficolin-3 level in the poor group was lower than that in the good group,and the C5b-9 level was higher than that in the good group,the difference was statistically significant(P<0.05).The area under curve(AUC)of serum Ficolin-3 and C5b-9 in predicting cardiovascular adverse events in elderly patients with AMI were 0.762 and 0.835 respectively.The combined prediction of the area under curve was 0.912.The results of multivariate logistic regression analysis showed that Killip’s cardiac function grade wasⅢ-Ⅳ,Ficolin-3≤14.89μg/ml,C5b-9≥185.14 ng/ml were independent risk factors for cardiovascular adverse events in elderly AMI patients(P<0.05).Conclusion The serum Ficolin-3 and C5b-9 are closely related to the occurrence of cardiovascular adverse events in elderly patients with AMI.The combined detection of the serum Ficolin-3 and C5b-9 has high predictive value for the occurrence of cardiovascular adverse events.