急性心肌梗死患者血清sST2、Hcy、IL-33水平与冠脉狭窄程度及MACE的关系研究

Study on the relationship between serum sST2,Hcy,IL-33 levels and degree of coronary artery stenosis and MACE in patients with acute myocardial infarction

目的探讨急性心肌梗死(AMI)患者血清可溶性生长刺激表达因子2(sST2)、同型半胱氨酸(Hcy)、白细胞介素(IL)-33水平与冠脉狭窄程度及主要不良心血管事件(MACE)的关系。方法回顾性选取该院于2021年5月至2023年5月收治的139例AMI患者,按照是否发生MACE,分为预后良好组54例,预后不良组85例。采用Spearman相关性分析AMI患者血清sST2、Hcy、IL-33水平与冠脉狭窄程度的关系。采用多因素Logistic回归分析患者发生MACE的影响因素,以及绘制受试者工作特征(ROC)曲线评价血清sST2、Hcy、IL-33水平对AMI患者发生MACE的预测价值。结果预后不良组血清sST2、Hcy、IL-33水平显著高于预后良好组,差异有统计学意义(P<0.05)。重度狭窄、中度狭窄患者血清sST2、Hcy、IL-33水平均明显高于轻度狭窄患者,差异有统计学意义(P<0.05)。Spearman相关性分析显示,血清sST2、Hcy、IL-33水平与冠脉狭窄程度呈正相关(P<0.05)。血清Hcy、sST2、IL-33均是影响AMI患者发生MACE的危险因素。ROC曲线分析显示,血清sST2、Hcy、IL-33水平对于AMI患者发生MACE的预测价值的曲线下面积(AUC)分别为0.838、0.726和0.800,灵敏度分别为87.1%、80.0%和84.7%,特异度分别为77.8%、68.5%和77.8%,三者联合对AMI患者发生MACE的预测价值的AUC为0.906,灵敏度和特异度分别为88.2%、90.7%。结论血清sST2、Hcy、IL-33水平对于AMI患者发生MACE具有一定的预测价值。

Objective To investigate the relationship between serum soluble growth stimulating expression gene 2 protein(sST2),homocysteine(Hcy)and interleukin(IL)-33 levels and degree of coronary artery stenosis and major cardiovascular adverse events(MACE)in patients with acute myocardial infarction(AMI).Methods A total of 139 patients with AMI admitted to a hospital from May 2021 to May 2023 were retrospectively selected and divided into a good prognosis group(54 cases)and a poor prognosis group(85 cases)according to the occurrence of MACE.Spearman correlation was used to analyze the relationship between serum sST2,Hcy,IL-33 levels and the degree of coronary artery stenosis in AMI patients.Multivariate Logistic regression was used to analyze the influencing factors of MACE occurrence in patients,and receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of serum sST2,Hcy and IL-33 levels for MACE occurrence in AMI patients.Results Serum levels of sST2,Hcy and IL-33 in the poor prognosis group were significantly higher than those in the good prognosis group,and the difference was statistically significant(P<0.05).Serum levels of sST2,Hcy and IL-33 in patients with severe and moderate stenosis were significantly higher than those in patients with mild stenosis,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that serum sST2,Hcy and IL-33 levels were positively correlated with the degree of coronary artery stenosis(P<0.05).Serum Hcy,sST2 and IL-33 are risk factors for MACE in AMI patients.ROC curve analysis showed that the area under the curve(AUC)of serum sST2,Hcy and IL-33 levels for predicting the occurrence of MACE in AMI patients was 0.838,0.726 and 0.800,and the sensitivity was 87.1%,80.0%and 84.7%,respectively.The specificity was 77.8%,68.5%and 77.8%,respectively.The AUC of the combined prediction value of MACE in AMI patients was 0.906,and the sensitivity and specificity were 88.2%and 90.7%,respectively.Conclusion Serum sST2,Hcy and IL-33 levels have certain predictive value for MACE in patients with AMI.