急性心肌梗死患者经皮冠脉介入术后血清Omentin-1、BDNF、sST2水平与左心室重构及MACE关系研究

Relationship between Serum Omentin- 1,BDNF,sST2 and Left Ventricular Remodeling, MACE in Patients with Acute Myocardial Infaction after Percutaneous Coronary Intervention

目的 探讨急性心肌梗死(acute myocardial infarction, AMI)患者血清网膜素-1(Omentin-1)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、可溶性生长刺激表达基因2(soluble growth stimulation expressed gene 2,sST2)蛋白水平与左心室重构及主要心血管不良事件(major adverse cardiac event, MACE)的关系。方法 选取2020年1月至2022年1月收治的286例行经皮冠脉介入术(percutaneous coronary intervention, PCI)的AMI患者作为观察组,以同期收治的未接受PCI术治疗的286例AMI患者为对照组。比较两组治疗前血清Omentin-1、BDNF和sST2水平;随访6个月,根据观察组术后6个月内是否发生MACE将其分为MACE组(35例)和非MACE组(251例)。比较3组患者的一般资料,PCI术后血清Omentin-1、BDNF和sST2水平,采用超声心动图检测PCI术后左心房内径(left atrial diameter, LAD)、左心室舒张末内径(left ventricular end-diastolic diameter, LVEDD)、右心室内径(right ventricular diameter, RVD)、室间隔厚度(interventricular septal thickness, IVST)、左心室后壁舒张末期厚度(left ventricular posterior wall thickness at end diastole, LVPWTd)、左心室射血分数(left ventricular ejection fraction,LVEF)和左心室质量指数(left ventricular mass index, LVMI)等心室重构指标。采用Pearson相关性分析术后血清Omentin-1、BDNF和sST2水平与心室重构之间的关系,采用受试者操作特征(receiver operating characteristic, ROC)曲线分析血清Omentin-1、BDNF、sST2对PCI术后MACE的预测价值。结果 MACE组PCI术后血清Omentin-1的表达量较非MACE组低,BDNF和sST2水平较非MACE组高(P均<0.05)。MACE组术后LAD、LVEDD、RVD、LVPWD、IVST和LVMI值较非MACE组高,LVEF值较非MACE组低(P均<0.05)。Pearson相关性分析结果显示,患者血清BDNF、sST2水平均与LAD、LVEDD、IVST和LVMI值呈正相关,与LVEF呈负相关,Omentin-1水平与LAD、LVEDD、IVST和LVMI值呈负相关,与LVEF呈正相关(P均<0.05)。ROC曲线分析结果表明,血清Omentin-1(AUC=0.747)、BDNF(AUC=0.744)和sST2(AUC=0.784)水平均对AMI患者PCI术后MACE的发生有预测价值(P均<0.05)。结论 血清Omentin-1、BDNF和sST2水平与AMI患者的心室重构密切相关,且对PCI术后MACE的发生有预测价值。

Objective To explore the relationship between serum omentin-1 (Omentin-1),brain-derived neurotrophic factor(BDNF),soluble growth stimulation expressed gene2 (s ST2) and left ventricular remodeling,major adverse cardiac events (MACE)in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods A total of 286 AMI patients admitted to our hospital from January 2020 to January 2022 undergoing PCI were selected as the observation group,and 286AMI patients admitted to our hospital without PCI during the same period were selected as the control group.All were followed up for 6months.Observation group was divided into MACE group (35 cases) and non-MACE group (251 cases) according to the occurrence of MACE within 6 months after operation.The general data and levels of serum Omentin-1,BDNF and s ST2 after PCI in the three groups were compared.The ventricular remodeling indexes[left atrial diameter (LAD),left ventricular end-diastolic diameter(LVEDD),right ventricular diameter (RVD),interventricular septal thickness (IVST),left ventricular posterior wall thickness at end diastole (LVPWTd),left ventricular ejection fraction (LVEF),left ventricular mass index (LVMI)]were detected by echocardiography after PCI.The relationship between postoperative serum Omentin-1,BDNF,s ST2 and ventricular remodeling was analyzed by Pearson correlation analysis.The predictive value of serum Omentin-1,BDNF and s ST2 for MACE was analyzed by ROC curves.Results The level of serum Omentin-1 in MACE group was lower than that in non-MACE group,while levels of BDNF and s ST2 were higher than those in non-MACE group.LAD,LVEDD,RVD,LVPWD,IVST and LVMI in MACE group were higher than those in non-MACE group,while LVEF was lower than that in non-MACE group (all P<0.05).The results of Pearson correlation analysis showed that levels of serum BDNF and s ST2 were positively correlated with LAD,LVEDD,IVST and LVMI,while negatively correlated with LVEF.The level of serum Omentin-1 was negatively correlated with LAD,LVEDD,IVST and LVMI,while positively correlated with LVEF (all P<0.05).The results of ROC curves analysis showed that serum Omentin-1 (AUC=0.747),BDNF(AUC=0.744) and s ST2 (AUC=0.784) were of predictive values for MACE (all P<0.05).Conclusion The levels of serum Omentin-1,BDNF and s ST2 are closely related to ventricular remodeling in AMI patients,which all have predictive value for the occurrence of MACE after PCI.