急性ST段抬高型心肌梗死患者入院血清白蛋白水平与梗死相关动脉自发再通的关系

Relationship between admission serum albumin level and spontaneous recanalization of infarct-related arteries in patients with acute ST segment elevation myocardial infarction

目的:探讨急性ST段抬高型心肌梗死(STEMI)患者入院血清白蛋白水平与梗死相关动脉自发再通的关系。方法:选取确诊为STEMI并在12 h内急诊行冠状动脉造影的患者212例。根据梗死相关动脉是否自发再通将患者分为非自发再通组(NSR组,n=153)和自发再通组(SR组,n=59)。采用logistic回归筛选梗死相关动脉自发再通的影响因素,采用ROC曲线评价入院血清白蛋白水平预测梗死相关动脉自发再通的价值。结果:SR组患者入院血清白蛋白水平高于NSR组(P<0.001)。Logistic回归分析结果显示,入院血清白蛋白水平(OR=1.241,95%CI=1.160~1.328)和高敏C反应蛋白(hs-CRP)水平(OR=0.730,95%CI=0.534~0.996)均是STEMI患者梗死相关动脉自发再通的独立影响因素。ROC曲线分析结果显示,入院血清白蛋白水平预测梗死相关动脉自发再通的曲线下面积为0.832(95%CI=0.774~0.879,P<0.001),截断值为40.48 g/L时,敏感度为84.7%,特异度为68.6%。结论:入院血清白蛋白水平是STEMI患者梗死相关动脉自发再通的独立预测因素。

Aim:To investigate the relationship between admission serum albumin level and spontaneous recanalization of infarct-related arteries in patients with acute ST segment elevation myocardial infarction(STEMI).Methods:A total of212 patients who were diagnosed as STEMI and underwent emergent coronary angiography within 12 hours were selected,and allocated into non-spontaneous recanalization group(NSR group,n=153) and spontaneous recanalization group(SR group,n=59) according to spontaneous recanalization of infarct-related arteries.Logistic regression analysis was used to screen the predictors of spontaneous recanalization,and ROC curve was used to evaluate the value of admission serum albumin level for predicting spontaneous coronary recanalization.Results:Admission serum albumin level in the SR group was significantly higher than that in the NSR group(P<0.001).Logistic regression analysis showed that admission serum albumin level(OR=1.241,95% CI=1.160-1.328) and hs-CRP(OR=0.730,95% CI=0.534-0.996) were independent predictors of spontaneous recanalization of infarct-related arteries in STEMI patients.ROC curve results showed that the area under ROC curve of admission serum albumin level predicting spontaneous recanalization of infarct-related arteries was0.832(95% CI=0.774-0.879,P<0.001);when the cut-off value was 40.48 g/L,the sensitivity was 84.7%,and the specificity was 68.6%.Conclusion:Admission serum albumin level is an independent predictor of spontaneous recanalization of infarct-related arteries in patients with STEMI.