血清Sestrin2、BUN、Hcy与2型糖尿病合并急性心肌梗死患者PCI术后短期预后的关系

Relationship between serum Sestrin2,BUN,Hcy and short-term prognosis of patients with type 2 diabetes mellitus complicated with acute myocardial infarction after PCI

目的探究血清应激诱导蛋白2(stress-induced protein 2,Sestrin2)、尿素氮(blood urea nitrogen,BUN)、同型半胱氨酸(homocysteine,Hcy)与2型糖尿病(type 2 diabetes mellitus,T2DM)合并急性心肌梗死(acute myocardial infarction,AMI)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后短期预后的关系。方法选取2020年5月至2023年5月在山西省长治医学院附属和平医院收治的500例T2DM患者作为研究对象,通过冠状动脉造影确诊为AMI的患者作为并发AMI组(244例),未并发AMI的患者作为未并发AMI组(256例)。根据患者PCI术后不良心血管事件(major adverse cardiovascular events,MACE)发生情况,将发生MACE的患者纳入预后不良组,未发生MACE的患者入预后良好组,比较各组血清Sestrin2、BUN、Hcy水平。Logistic回归分析影响T2DM合并AMI患者PCI术后预后不良发生的因素。结果并发AMI组患者血清Sestrin2为(11.41±1.56)μg/L、BUN为(10.96±1.38)mmol/L、Hcy为(19.63±2.06)μmol/L,高于未并发AMI组的(9.25±1.24)μg/L、(8.63±1.15)mmol/L、(15.54±1.86)μmol/L(P<0.05)。预后不良患者LDL-C为(2.52±0.89)mmol/L、TG为(4.42±1.04)mmol/L、Sestrin2为(14.66±1.79)μg/L、BUN为(15.39±1.94)mmol/L、Hcy为(22.99±2.68)μmol/L、FBG为(10.25±1.23)mmol/L,高于预后良好组的(2.26±0.76)mmol/L、(3.94±0.98)mmol/L、(10.23±1.37)μg/L、(9.35±1.28)mmol/L、(18.41±2.06)μmol/L、(8.37±0.85)mmol/L(P<0.05)。多因素分析显示,Sestrin2、BUN、Hcy是影响T2DM合并AMI患者PCI术后预后不良的危险因素(P<0.05)。结论T2DM合并AMI患者血清Sestrin2、BUN、Hcy水平升高,且与PCI术后不良预后相关。

Objective To investigate the relationship between serum Sestrin2,urea nitrogen(BUN),homocysteine(Hcy)and short-term prognosis of patients with type 2 diabetes mellitus(T2DM)complicated with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 500 T2DM patients admitted to our hospital from May.2020 to May.2023 were regarded as the study subjects.Patients diagnosed with AMI through coronary angiography were included in the group with concurrent AMI(244 cases),while patients without concurrent AMI were included in the group without concurrent AMI(256 cases).According to the incidence of adverse cardiovascular events(MACE)after PCI,patients with MACE were included in the poor prognosis group,while patients without MACE were included in the good prognosis group,and the serum levels of Sestrin2,BUN,and Hcy in each group were compared.Logistic regression was applied to analyze the factors that affected the occurrence of poor prognosis after PCI in patients with T2DM and AMI.Results The levels of serum Sestrin2(11.41±1.56)μg/L,BUN(10.96±1.38)mmol/L and Hcy(19.63±2.06)μmol/Lin AMI group were higher than those in the non-AMI group(9.25±1.24)μg/L,(8.63±1.15)mmol/L,(15.54±1.86)μmol/L(P<0.05).The levels of LDL-C(2.52±0.89)mmol/L,TG(4.42±1.04)mmol/L,Sestrin2(14.66±1.79)μg/L,BUN(15.39±1.94)mmol/L,Hcy(22.99±2.68)μmol/L,and FBG(10.25±1.23)mmol/L in patients with poor prognosis were higher than those in the group with good prognosis(2.26±0.76)mmol/L,(3.94±0.98)mmol/L,(10.23±1.37)μg/L,(9.35±1.28)mmol/L(18.41±2.06)μmol/L,(8.37±0.85)mmol/L(P<0.05).Multivariate analysis showed that Sestrin2,BUN,and Hcy were risk factors for poor prognosis after PCI in patients with T2DM and AMI(P<0.05).Conclusion The serum levels of Sestrin2,BUN,and Hcy are elevated in patients with T2DM and AMI,and are associated with poor prognosis after PCI.