血清脂蛋白相关磷脂酶A2及巨噬细胞移动抑制因子水平与急性心肌梗死患者经皮冠状动脉介入治疗预后的相关性

The correlation between serum lipoprotein associated phospholipase A2 and macrophage migration inhibitory factor levels and the prognosis of percutaneous coronary intervention in patients with acute myocardial infarction

目的观察血清脂蛋白相关磷脂酶A_(2)(LP-PLA_(2))、巨噬细胞移动抑制因子(MIF)在急性心肌梗死(AMI)患者中的表达,分析二者与经皮冠状动脉介入(PCI)治疗预后的关系。方法前瞻性选取2019年6月至2020年4月于本院接受PCI治疗的88例AMI患者作为研究对象,PCI治疗后均随访12个月,观察并记录AMI患者PCI后12个月不良心血管事件发生情况,收集患者临床资料,比较不同预后患者临床资料及血清LP-PLA_(2)、MIF水平,分析血清LP-PLA_(2)、MIF水平与AMI患者PCI治疗预后的关系。结果PCI治疗后12个月,88例患者中预后不良35例,占39.77%,预后良好53例,占60.23%。预后不良患者入院时血清LP-PLA_(2)、MIF水平均高于预后良好患者,差异有统计学意义(P<0.05);PCI后不同预后AMI患者年龄、性别、病变支数、发病至PCI时间比较差异无统计学意义。ROC分析结果显示,血清LP-PLA_(2)、MIF单独及联合预测AMI患者PCI治疗预后不良风险的AUC分别为0.858、0.839、0.878,均有一定预测价值,且血清LP-PLA_(2)取227.805μg/L,血清MIF取13.320 ng/L时,其灵敏度、特异度较高。结论血清LP-PLA_(2)、MIF高表达与AMI患者PCI治疗后预后不良存在一定联系。

Objective To observe the expression of serum lipoprotein associated phospholipase A_(2)(LP-PLA_(2))and macrophage migration inhibitory factor(MIF)in patients with acute myocardial infarction(AMI),and analyze their relationship with the prognosis of percutaneous coronary intervention(PCI)treatment.Methods A prospective study was conducted on 88 AMI patients who underwent PCI treatment in our hospital from June 2019 to April 2020 were prospectively selected as the study subjects.All patients were followed up for 12 months after PCI treatment,and the incidence of adverse cardiovascular events in AMI patients was observed and recorded 12 months after PCI,clinical data of patients with different prognosis and serum levels of LP-PLA_(2) and MIF were collected and compared,the relationship between serum levels of LP-PLA_(2) and MIF and the prognosis of AMI patients undergoing PCI treatment was analyzed.Results After 12 months of PCI treatment,out of 88 patients,35 had poor prognosis,accounting for 39.77%,and 53 had good prognosis,accounting for 60.23%.The serum levels of LP-PLA_(2) and MIF in patients with poor prognosis at admission were higher than those in patients with good prognosis,and the differences were statistically significant(P<0.05);there was no statistically significant difference in age,gender,number of lesions,and time from onset to PCI among AMI patients with different prognosis after PCI.ROC analysis showed that,the AUC of serum LP-PLA_(2) and MIF alone and in combination for predicting the risk of poor prognosis in AMI patients undergoing PCI treatment were 0.858,0.839,and 0.878,respectively,both of which have certain predictive value,serum LP-PLA_(2) was taken as 227.805μg/L,serum MIF was taken at 13.320 ng/L,its sensitivity and specificity were high.Conclusion There is certain correlation between the high expression of serum LP-PLA_(2) and MIF and the poor prognosis of AMI patients after PCI treatment.