FGF−21、IMA、MCP−1与急性心肌梗死患者预后的关系

Relationship of FGF-21,IMA and MCP-1 with the prognosis of patients with acute myocardial infarction

目的 研究成纤维细胞生长因子-21 (fibroblast growth factor 21,FGF-21)、缺血修饰白蛋白(ischemia modified albumin,IMA)、单核细胞趋化蛋白-1 (monocyte chemotactic protein-1,MCP-1)与急性心肌梗死(acute myocardial Infarction,AMI)患者预后的关系。方法 选择本院2017年5月-2020年7月诊治的110例AMI患者,根据患者预后情况分为预后不良组和预后良好组,收集患者临床资料,分析其血清FGF-21、IMA、MCP-1水平与AMI患者预后的关系以及诊断主要不良心血管事件(major adverse cardiovascular event,MACE)发生的效能。结果 预后良好组患者血清FGF-21、IMA、MCP-1水平低于预后不良组,差异有统计学意义(P<0.05);血清FGF-21、IMA、MCP-1水平3者联合预测预后的ROC曲线下面积(area under curve,AUC)以及敏感度最高(P<0.05);不同血清FGF-21、IMA、MCP-1水平患者MACE发生率比较,差异有统计学意义(P<0.05);Cox单因素以及多因素分析结果显示,FGF-21>150.12 ng/L、IMA> 75.78 U/mL、MCP-1> 49.67 pg/mL、肌酸激酶-同工酶(CK-MB)> 35 U/L以及心肌肌钙蛋白Ⅰ(cTnⅠ)> 75.78 U/mL均是影响AMI患者预后不良的独立危险因素(P<0.05)。结论 血清FGF-21、IMA、MCP-1水平均可较好地预测AMI患者预后不良的发生,且三者联合预测效能更高,同时血清FGF-21、IMA、MCP-1水平增高与MACE的发生密切相关,是AMI患者预后不良的危险因素。

Objective:To study the relationship of fibroblast growth factor 21(FGF-21),ischemia modified albumin(IMA)and monocyte chemoattractant protein-1(MCP-1)with the prognosis of patients with acute myocardial infarction(AMI).Methods:A total of 110 patients with AMI were admitted to the hospital between May 2017 and July 2020.They were divided into poor prognosis group and good prognosis group according to the prognosis.The clinical data of the patients enrolled were collected,and the levels of serum FGF-21,IMA and MCP-1 were detected.The relationship between the above-mentioned serum indicators and the prognosis of patients with AMI,and the efficiency in diagnosing major adverse cardiovascular event(MACE)were analyzed.Results:The levels of serum FGF-21,IMA and MCP-1 in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05).The area under the ROC curve(AUC)and sensitivity of the combination of serum FGF-21,IMA and MCP-1 for prognosis were the highest(P<0.05).The incidence of MACE showed statistically significant differences between patients with different levels of serum FGF-21,IMA and MCP-1(P<0.05).Cox univariate analysis and multivariate analysis found that FGF-21 level>150.12 ng/L,IMA level>75.78 U/ml,MCP-1 level>49.67pg/ml,CK-MB level>35 U/L and cTnⅠlevel>75.78 U/ml were independent risk factors for poor prognosis of patients with AMI(P<0.05).Conclusion:The levels of serum FGF-21,IMA and MCP-1 can be used to better predict the occurrence of poor prognosis in patients with AMI,and the combination of the three has higher predictive efficiency.Meanwhile,high levels of serum FGF-21,IMA and MCP-1 are closely related to the occurrence of MACE,which indicates that they are risk factors for poor prognosis of patients with AMI.