心脏超声相关参数、实验室指标对STEMI患者PCI治疗后短期预后的预测价值

doi:10.3969/j.issn.1671-7171.2024.04.010

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摘要【目的】探讨心脏超声相关参数、实验室指标对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)治疗后短期预后的预测价值。【方法】选取2019年4月至2022年4月于西安高新医院就诊的80例STEMI患者,所有患者均行PCI治疗,随访1个月,按照是否发生不良心血管事件(MACE)分为预后良好组和预后不良组。比较两组患者一般资料、心脏超声参数[左室壁厚度(LVPW)、左房容积(LAV)、心输出量(CO)、左室射血分数(LVEF)]、实验室指标[血红蛋白(Hb)、中性粒细胞与淋巴细胞比值(NLR)、白细胞介素-6(IL-6)、淀粉样蛋白(SAA)];采用受试者工作特征(ROC)曲线分析各指标对STEMI患者PCI治疗后短期预后的预测价值;采用多因素Logistic回归分析STEMI患者PCI治疗后预后不良的危险因素。【结果】预后良好组killip分级≥Ⅲ级、病变支数≥2支的占比及LVPW、LAV、IL-6、SAA、NLR显著低于预后不良组,CO、LVEF显著高于预后不良组,差异均具有统计学意义(P<0.05)。ROC曲线分析结果显示:LVPW、LAV、CO、LVEF、IL-6、SAA、NLR评估STEMI患者PCI治疗后短期预后的曲线下面积分别为0.646、0.772、0.704、0.822、0.901、0.818、0.729。多因素Logistic回归分析结果显示:killip分级≥Ⅲ级、病变支数≥2支、LVPW≥6.835 mm、LAV≥56.495 mL、CO≤4.610 L/min、LVEF≤55.535 %、IL-6≥5.665 ng/L、SAA≥4.890 mg/L、NLR≥3.005是STEMI患者PCI治疗后短期预后不良的危险因素(P<0.05)。【结论】LVPW、LAV、CO、LVEF、IL-6、SAA、NLR可影响STEMI患者PCI治疗后短期预后,临床上可通过上述指标评估STEMI患者PCI治疗后短期预后情况。

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关键词 ： ST段抬高型心肌梗死, 血管成形术, 气囊, 冠状动脉, 超声检查, 预后

Abstract：【Objective】To investigate the value of cardiac ultrasound parameters and laboratory indexes in predicting short-term prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). 【Methods】A total of 80 STEMI patients admitted to Xi'an Gaoxin Hospital from April 2019 to April 2022 were selected. All patients underwent PCI and were followed up for 1 month. They were divided into good prognosis group and poor prognosis group according to whether adverse cardiovascular events (MACE) occurred. General data, cardiac ultrasound parameters[left ventricular wall thickness (LVPW), left atrial volume (LAV), cardiac output (CO), left ventricular ejection fraction (LVEF)], laboratory indicators [hemoglobin (Hb), neutrophil to lymphocyte ratio (NLR), interleukin-6 (IL-6), amyloid protein (SAA)] of the two groups were compared. Receiver operating characteristic (ROC) curve was used to analyze the prognostic value of each index in STEMI patients after PCI. Multivariate Logistic regression was used to analyze the risk factors of poor prognosis in STEMI patients after PCI. 【Results】The proportion of killip grade ≥Ⅲ and lesion number ≥2 in the good prognosis group was significantly lower than that in the poor prognosis group. Levels of LVPW, LAV, IL-6, SAA and NLR in the good prognosis group were significantly lower than those in the poor prognosis group, while scores of CO and LVEF were significantly higher than those in the poor prognosis group, with statistical significance (P<0.05). ROC curve analysis results showed that the area under the curve of LVPW, LAV, CO, LVEF, IL-6, SAA and NLR to evaluate the short-term prognosis of STEMI patients after PCI were 0.646, 0.772, 0.704, 0.822, 0.901, 0.818 and 0.729, respectively. Multivariate Logistic regression analysis showed that: killip grade ≥Ⅲ, number of lesions ≥2, LVPW≥6.835 mm, LAV≥56.495 mL, CO≤4.610 L/min, LVEF≤ 55.535%, IL-6≥5.665 ng/L, SAA≥4.890 mg/L and NLR≥3.005 were risk factors for poor short-term prognosis after PCI in STEMI patients (P<0.05).【Conclusion】LVPW, LAV, CO, LVEF, IL-6, SAA, NLR can affect the short-term prognosis of STEMI patients after PCI. Thus, the short-term prognosis of STEMI patients after PCI can be evaluated clinically by the above indicators.

Key words： ST Elevation Myocardial Infarction Angioplasty, Balloon, Coronary Ultrasonography Prognosis

收稿日期: 2023-02-09

中图分类号:

R542.22

通讯作者: ^*E-mail:994686572@qq.com

引用本文:

窦盼, 周雪亮, 郑德良. 心脏超声相关参数、实验室指标对STEMI患者PCI治疗后短期预后的预测价值[J]. 医学临床研究, 2024, 41(4): 515-518.
DOU Pan, ZHOU Xueliang, ZHENG Deliang. Prognostic Value of Cardiac Ultrasound Parameters and Laboratory Indexes in Short-Term Prognosis of STEMI Patients after PCI. JOURNAL OF CLINICAL RESEARCH, 2024, 41(4): 515-518.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.04.010 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I4/515