摘要
目的:本研究初步探讨基线可溶性致癌抑制因子2(sST2)水平与急性ST段抬高型心肌梗死(STEMI)患者30 d主要不良心血管事件(MACE)发生的关系。方法:连续入组2015-05-01至2015-07-30期间就诊我院并明确诊断STEMI患者121例。依据基线sST2中位数水平分为sST2低值组(sST2≤56.68 ng/ml,n=61)、sST2高值组(sST2>56.68 ng/ml,n=60)。比较两组患者的临床资料及30 d的MACE(定义为死亡、新发慢性心力衰竭)发生率。结果:(1)两组在收缩压、Killip心功能分级≥Ⅱ级、血清肌钙蛋白I峰值、N末端B型利钠肽原(NT-pro BNP)、超敏C反应蛋白(hs-CRP)、左心室射血分数(LVEF)等方面差异均有统计学意义(P均<0.05)。(2)基线sST2水平与心率(r=0.271,P=0.003)、hs-CRP(r=0.359,P=0.000)、肌钙蛋白I(r=0.324,P=0.000)及NT-pro BNP(r=0.425,P=0.000)均呈正相关;与收缩压(r=-0.226,P=0.013)及LVEF(r=-0.406,P=0.000)均呈负相关。(3)sST2低值组MACE发生率(8.2%)低于sST2高值组(30%),差异有统计学意义(P=0.002)。(4)多因素Cox回归分析显示sST2>56.68 ng/ml是STEMI患者30 d出现MACE的危险因素(危险比=1.152,95%可信区间:1.078~1.231,P=0.000)。结论:STEMI患者基线sST2水平升高提示近期死亡及新发心力衰竭风险增加。
Objective：To preliminarily investigate the relationship between the baseline level of serum soluble ST2（sST2） and 30-day MACE occurrence rate in patients with ST-elevation myocardial infarction（STEMI）.Methods：A total of 121 patients with confirmed diagnosis of STEMI in our hospital from 2015-05-01 to 2015-07-30 were consecutively enrolled.According to baseline sST2 level,the patients were divided into 2 groups：Low sST2 group,the patients with sST2≤56.68 ng/ml,n=61 and High sST2 group,the patients with sST2〉56.68 ng/ml,n=60.Clinical condition and 30-day MACE（defined as death and new onset of congestive heart failure） occurrence rate were compared between 2 groups.Results：1 The systolic blood pressure（SBP）,Killip class≥II grade,blood levels of c TNI,NT-pro BNP,hs-CRP and LVEF were different between 2 groups,all P0.05.2 Baseline sST2 level was positively related to heart rate（r=0.271,P=0.003）,Hs-CRP（r=0.359,P=0.000）,c TNI（r=0.324,P=0.000） and NT-pro BNP（r=0.425,P=0.000）;negatively related to SBP（r=-0.226,P=0.013） and LVEF（r=-0.406,P=0.000）.3 30-day MACE occurrence rate was different between 2 groups（8.2% vs 30%,P=0.002）.4 Multivariate Cox regression analysis presented that sST256.68 ng/ml was the risk factor for 30-day MACE occurrence（HR=1.152,95% CI 1.078-1.231,P=0.000）.Conclusion：Increased baseline level of sST2 implied the higher incidence of death and new onset of congestive heart failure in STEMI patients.
出处
《中国循环杂志》
CSCD
北大核心
2017年第1期41-45,共5页
Chinese Circulation Journal
基金
北京力生心血管健康基金会2014中国心血管疾病药物治疗研究基金项目优秀课题(LSG2014-2015)
