血清cMyBP-C、ICAM-1、ADAMTS-1水平与急性心肌梗死患者预后的相关性

Correlation between levels of serum cMyBP-C,ICAM-1,ADAMTS-1 and prognosis of patients with acute myocardial infarction

目的探讨血清心脏肌球蛋白结合蛋白C(cMyBP-C)、细胞间黏附分子-1(ICAM-1)、Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶(ADAMTS-1)水平与急性心肌梗死(AMI)患者预后的相关性。方法选取2021年4月至2023年4月于郑州市惠济区人民医院行经皮冠状动脉介入(PCI)术治疗的142例AMI患者作为研究对象,根据入院时Gensini积分将患者分为轻度狭窄组(49例)、中度狭窄组(55例)、重度狭窄组(38例)。比较三组术前血清cMyBP-C、ICAM-1、ADAMTS-1水平,比较不同预后患者(术前、术后7 d、术后14 d)血清cMyBP-C、ICAM-1、ADAMTS-1水平,采用Pearson分析相关性,采用绘制受试者工作特征(ROC)曲线评估预测价值,分析各指标不同水平患者预后不良的危险度。结果三组术前血清cMyBP-C、ICAM-1、ADAMTS-1水平比较:重度狭窄组>中度狭窄组>轻度狭窄组(P<0.05);术后7 d、术后14 d预后不良患者血清cMyBP-C、ICAM-1、ADAMTS-1水平高于预后良好患者(P<0.05);预后良好患者术后血清cMyBP-C、ICAM-1、ADAMTS-1水平呈下降趋势(P<0.05);术前血清cMyBP-C、ICAM-1、ADAMTS-1水平与Gensini积分均呈正相关(P<0.05);术后14 d联合预测AMI患者PCI术后预后不良AUC为0.813;术后14 d血清cMyBP-C、ICAM-1、ADAMTS-1高水平患者PCI术后预后不良的危险度是低水平的4.410、5.217、3.638倍(P<0.05)。结论血清cMyBP-C、ICAM-1、ADAMTS-1水平与AMI患者PCI术后转归情况密切相关,临床可根据各指标水平变化给予针对性干预,进而改善患者预后。

Objective To investigate the correlation between serum levels of cardiac myosin-binding protein C(cMyBP-C),intercellular cell adhesion molecule-1(ICAM-1),and a disintegrin and metalloproteinase with thrombospondin motifs 1(ADAMTS-1)and prognosis of patients with acute myocardial infarction(AMI).Methods A total of 142 patients with AMI who underwent percutaneous coronary intervention(PCI)in Huiji District People's Hospital of Zhengzhou from April 2021 to April 2023 were selected as the study objects.According to the Gensini scores at admission,the patients were divided into a mild stenosis group(49 cases),a moderate stenosis group(55 cases)and a severe stenosis group(38 cases).Preoperative serum levels of cMyBP-C,ICAM-1 and ADAMTS-1 were compared among the three groups,and serum levels of cMyBP-C,ICAM-1 and ADAMTS-1 in patients with different prognosis(preoperative,7 d and 14 d after surgery)were compared,and the correlation was analyzed by Pearson.The predictive value was evaluated by receiver operating characteristic(ROC)curve,and the risk of poor prognosis was analyzed at different levels of each indicator.Results Preoperative serum levels of cMyBP-C,ICAM-1 and ADAMTS-1 were compared among the three groups:severe stenosis group>moderate stenosis group>mild stenosis group(P<0.05);Serum levels of cMyBP-C,ICAM-1 and ADAMTS-1 in patients with poor prognosis were higher than those in patients with good prognosis 7 and 14 days after surgery(P<0.05).The serum levels of cMyBP-C,ICAM-1 and ADAMTS-1 in patients with good prognosis were decreased(P<0.05).The serum levels of cMyBP-C,ICAM-1 and ADAMTS-1 were positively correlated with Gensini scores before operation(P<0.05).The AUC of AMI patients with poor prognosis after PCI was 0.813 at 14 days after surgery.The risk of poor prognosis in patients with high levels of serum cMyBP-C,ICAM-1 and ADAMTS-1 at 14 days after PCI was 4.410,5.217,3.638 times as much as that in patients with low levels(P<0.05).Conclusion Serum levels of cMyBP-C,ICAM-1 and ADAMTS-1 are closely related to the outcome of AMI patients after PCI,and targeted interventions can be given according to the changes in the level of each index to improve the prognosis of patients.