血清KYNA、EP4在老年急性心肌梗死患者中表达水平及其与心肌损伤预后的相关性

Serum Kynurenic Acid and Prostaglandin E receptor 4 Levels in Elderly Patients with Acute Myocardial Infarction and Their Correlation with Myocardial Injury Prognosis

目的探讨老年急性心肌梗死(AMI)患者血清犬尿喹啉酸(KYNA)、E-前列腺素受体4(EP4)表达与心肌损伤预后的相关性。方法选取长江大学附属仙桃市第一人民医院收治的87例老年AMI患者作为试验组,同时选择80例老年健康体检者作为对照组,试验组依据预后情况分为预后良好组(75例)及预后不良组(12例)。检测血清KYNA、EP4及心肌酶指标cTnI、CK-MB、CK表达水平;血清KYNA、EP4与心肌酶指标的相关性采用Pearson相关性分析;KYNA、EP4水平与老年AMI患者预后的关系采用Kaplan-Meier生存曲线分析;老年AMI患者预后不良的影响因素采用多因素COX回归分析。结果试验组TG、LDL-C及TC高于对照组(P<0.05),试验组患者血清KYNA及心肌酶指标cTnI、CK-MB及CK的表达水平升高,EP4表达水平降低(P<0.05);相关性分析显示,血清KYNA与心肌酶指标呈正相关,EP4与心肌酶指标呈负相关;血清KYNA低表达患者3年生存率高于高表达患者,EP4高表达患者3年生存率高于低表达患者。预后不良组cTnI、CK-MB、CK及KYNA水平高于预后良好组,EP4水平低于预后良好组(P<0.05),KYNA、EP4是AMI预后不良的影响因素(P<0.05)。结论老年AMI患者血清KYNA表达水平升高,血清EP4表达水平降低,二者与患者心肌损伤的预后相关。

Objective To explore the expression levels of serum kynurenic acid(KYNA)and prostaglandin E receptor 4(EP4)in elderly patients with acute myocardial infarction(AMI)and their correlation with the prognosis of myocardial injury.Methods Eighty-seven elderly patients with AMI admitted to Xiantao First People's Hospital Affiliated to Yangtze University were selected as the experimental group,while 80 older adults undergoing health checkups were selected as the control group.And patients in the experimental group were further divided into the good prognosis group(n=75)and the poor prognosis group(n=12)according to their prognosis.Serum levels of KYNA,EP4,and cardiac enzyme indexes cTnI,CK-MB,and CK were detected.The correlation between serum KYNA and EP4 levels and cardiac enzyme indexes was analyzed by Pearson correlation analysis.The relationship between serum KYNA and EP4 levels and prognosis of elderly patients with AMI was analyzed by Kaplan-Meier survival curve analysis.The influencing factors of poor prognosis in elderly patients with AMI were analyzed by multivariate Cox regression analysis.Results TG,LDL-C and TC in the experimental group were higher than those in the control group(P<0.05).Compared with patients in the control group,patients in the experimental group had increased expression levels of serum KYNA and cardiac enzyme indexes cTnI,CK-MB and CK,and decreased expression levels of EP4(P<0.05).Pearson correlation analysis showed that serum KYNA was positively correlated with cardiac enzyme indices,and EP4 was negatively correlated with cardiac enzyme indices.The 3-year survival rate of patients with low serum KYNA expression was higher than that of patients with high serum KYNA expression(P<0.05).The 3-year survival rate of patients with high EP4 expression was higher than that of patients with low EP4 expression(P<0.05).Compared with patients with good prognosis,patients with poor prognosis had higher levels of cTnI,CK-MB,CK,and KYNA,but lower levels of EP4(P<0.05).KYNA and EP4 were the influencing factors of poor prognosis of AMI(P<0.05).Conclusion Elderly patients with AMI have elevated serum KYNA expression levels and decreased serum EP4 expression levels,which are correlated with the prognosis of myocardial injury in patients.