急性心肌梗死患者PCI术后血浆vaspin、periostin及Lp-PLA2水平对不良心血管事件的预测价值

Predictive value of plasma vaspin,periostin and Lp-PLA2 levels for adverse cardiovascular events in patients with acute myocardial infarction after PCI

目的探讨急性心肌梗死(AMI)患者经皮冠状动脉介入术(PCI)后血浆腹腔脂肪型丝氨酸蛋白酶抑制剂(vaspin)、骨膜蛋白(periostin)及脂蛋白相关磷脂酶A_(2)(Lp-PLA_(2))水平对不良心血管事件(MACE)的预测价值.方法选取2019年3月至2021年3月医院收治的260例行PCI手术AMI患者,统计术后1年内MACE发生率,并根据是否发生MACE将其分为发生组和未发生组,单因素分析AMI患者PCI术后发生MACE的影响因素,logistic回归分析AMI患者PCI术后发生MACE的影响因素,受试者工作特征(ROC)曲线分析血浆vaspin、periostin及Lp-PLA_(2)对AMI患者PCI术后发生MACE的预测价值.结果260例AMI患者,在行PCI术后1年内MACE发生率为9.62%(25/260).两组年龄、高血压病史、疾病类型、左心室射血分数(LVEF%)、入院血糖、肌酐、三酰甘油(TG)、发病至治疗时间(OTN)、心肌梗死溶栓治疗(TIMI)分级、vaspin、periostin及Lp-PLA_(2)比较,差异均有统计学意义(P<0.05).Logistic回归分析显示,vaspin水平降低、periostin和Lp-PLA_(2)水平升高是AMI患者PCI术后发生MACE的独立危险因素(P<0.05).ROC曲线分析结果显示,vaspin、periostin及Lp-PLA_(2)对AMI患者PCI术后发生MACE预测的最佳截断点分别为1.02μg/L、154.8μg/L、284.70μg/L,ROC曲线下面积(AUC)分别为0.869、0.850、0.858,三者联合检测AUC为0.933.结论血浆vaspin、periostin及Lp-PLA_(2)水平均与AMI患者PCI术后发生MACE有关,且三者联合检测对AMI患者PCI术后发生MACE有较高预测价值.

Objective To investigate the levels of plasma peritoneal adipose serine protease inhibitor vaspin,periostin and lipoprotein-associated phospholipase A_(2)(Lp-PLA_(2))in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI),and their predictive value for major adverse cardiovascular events(MACE).Methods A total of 260 patients with AMI who underwent PCI surgery from March 2019 to March 2021 were selected.The incidence of MACE within 1 year after operation was recorded,and they were divided into occurrence group and non-occurrence group according to whether MACE occurred or not.Univariate analysis of the influencing factors of MACE after PCI in patients with AMI was conducted using logistic regression analysis.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of plasma vaspin,periostin and Lp-PLA_(2) on the occurrence of MACE in patients with AMI after PCI.Results Among 260 patients with AMI,the incidence of MACE within 1 year after PCI was 9.62%(25/260).There were significant differences in age,hypertension history,disease type,left ventricular ejection fraction(LVEF%),admission blood glucose,creatinine,triglyceride(TG),onset-to-needle time(OTN),thrombolysis in myocardial infarction(TIMI)grade,vaspin,periostin and Lp-PLA_(2) between the two groups(P<0.05).Logistic regression analysis showed that the decreased vaspin and the increased periodin and Lp-PLA_(2) were independent risk factors for MACE in patients with AMI after PCI(P<0.05).The results of ROC curve analysis showed that the optimal cut-off points of vaspin,periostin and Lp-PLA_(2) for the prediction of MACE in patients with AMI after PCI were 1.02μg/L,154.8μg/L and 284.70μg/L,respectively;and the AUCs were 0.869,0.850 and 0.858,respectively.The AUC of the three combined detection was 0.933.Conclusion Plasma vaspin,periostin and Lp-PLA_(2) levels are correlated to the occurrence of MACE in patients with AMI after PCI,and the combined detection of the three has a high predictive value for the occurrence of MACE in patients with AMI after PCI.