血清YKL-40、IL-33、copeptin水平与急性心肌梗死患者预后的关系

Relationship between serum YKL⁃40,IL⁃33,copeptin levels and prognosis of patients with acute myocardial infarction

目的 探讨血清甲壳质酶蛋白(YKL)-40、白介素-33(IL-33)、和肽素(copeptin)水平与急性心肌梗死患者预后的关系。方法 选择2020年9月至2021年3月秦皇岛市第一医院心内科的重症监护室(CCU)收治的200例急性心肌梗死患者作为研究对象,按照是否发生心血管不良事件将患者分为预后良好组和预后不良组。对比两组的血清YKL-40、IL-33、copeptin水平差异,采用Spearman相关性分析分析血清YKL-40、IL-33、copeptin水平与急性心肌梗死患者预后的关系,采用多因素Logistic回归分析急性心肌梗死患者预后不良的独立影响因素,绘制受试者工作特征曲线(ROC)评估血清YKL-40、IL-33、copeptin水平对急性心肌梗死患者预后不良的预测价值。结果 预后良好组的血清YKL-40、IL-33、copeptin水平均低于预后不良组,差异具有统计学意义(t=7.788、5.415、4.534,P<0.05)。Spearman相关分析结果表明,血清YKL-40、IL-33、copeptin水平与心肌梗死患者预后不良发生呈正相关(r=0.450、0.340、0.274,P均<0.001)。Logistic多因素回归分析显示,年龄、高血压、YKL-40、IL-33、Copeptin过度表达是急性心肌梗死患者预后不良的独立危险因素(P<0.05)。ROC曲线显示,血清YKL-40、IL-33、copeptin联合预测急性心肌梗死不良预后的效能更高,其曲线下面积(AUC)为0.872,灵敏度、特异度分别为79.0%、81.9%。结论 血清YKL-40、IL-33、copeptin水平与急性心肌梗死患者预后不良密切相关,其表达对急性心肌梗死预后具有良好的预测价值。

Objective To investigate the relationship between the levels of serum chitinase protein(YKL-40),interleukin-33(IL-33),and copeptin and the prognosis of patients with acute myocardial infarction(AMI).Methods A total of 200 patients with acute myocardial infarction admitted to the Intensive Care Unit(CCU)of the Cardiology Department at the First Hospital of Qinhuangdao City from September 2020 to March 2021 were selected as the study subjects.They were divided into two groups based on their prognosis:a good prognosis group and a poor prognosis group,depending on whether they experienced cardiovascular adverse events.The serum levels of YKL-40,IL-33 and copeptin between the two groups was measured and compared.Spearman correlation analysis was used to analyze the relationship between serum YKL-40,IL-33 and copeptin levels and the prognosis of patients with acute myocardial infarction.Multivariate logistic regression was used to analyze the independent influencing factors of poor prognosis in patients with acute myocardial infarction,and the receiver operating characteristic curve(ROC)was drawn to evaluate the predictive value of serum YKL-40,IL-33 and copeptin levels for poor prognosis in patients with acute myocardial infarction.Results The serum levels of YKL-40,IL-33 and copeptin in the group with a good prognosis were lower than those in the group with a poor prognosis group,and the differences were statistically significant(t=7.788,5.415,4.534,P<0.05).Spearman correlation analysis showed a positive correlation between serum YKL-40,IL-33 and copeptin levels and poor prognosis in patients with myocardial infarction(r=0.450,0.340,0.274,P<0.001).Logistic multivariate regression analysis revealed that age,hypertension,YKL-40,IL-33 and copeptin overexpression were independent risk factors for poor prognosis in patients with acute myocardial infarction(P<0.05).The ROC curve demonstrated that the combined effect of serum YKL-40,IL-33 and copeptin was more effective in predicting the adverse prognosis of acute myocardial infarction.The area under the curve(AUC)for serum YKL-40,IL-33 and copeptin was 0.872 with a sensitivity of 79.0%and specificity of 81.9%.Conclusion Serum levels of YKL-40,IL-33 and copeptin are closely associated with the poor prognosis of patients with acute myocardial infarction.Their expressions have a significant predictive value for the prognosis of acute myocardial infarction.