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脂联素和内脂素联合监测在预测急性心肌梗死PCI术后发生心力衰竭中的意义

  

  1. 1.山东省交通医院 心内科,山东 济南 250031; 2.中国医科大学第四医院 心内科,辽宁 沈阳 110032
  • 收稿日期:2015-12-22 出版日期:2016-06-05 发布日期:2016-06-06
  • 通讯作者: 通信作者:张琴,Email:1541421042@qq.com
  • 基金资助:
    辽宁省自然科学基金2013021011

Significance of adiponectin and visfatin joint monitoring in predicting heart failure after PCI #br# in acute myocardial infarction

  1. 1. Department of Cardiology, Traffic Hospital of Shandong Province, Jinan 250031,China;
    2. Department of Cardiology, the Fourth Hospital of China Medical University, Shenyang 110032,China
  • Received:2015-12-22 Online:2016-06-05 Published:2016-06-06
  • Contact: Corresponding author: Zhang Qin, Email: 1541421042@qq.com

摘要: 目的 探讨脂联素(APN)和内脂素联合监测在预测急性心肌梗死(AMI)PCI术后发生心力衰竭中的意
义。方法 选取行PCI治疗的AMI患者157例,根据PCI术后是否发生心力衰竭,将患者分为发生组(n =62)和未
发生组(n =95),选取健康者40例作为对照组,收集所有研究对象超声心动图及血生化检查资料,所有患者于行PCI
术后次日,对照组于体检当日,利用全自动酶联荧光分析仪检测血清APN 和内脂素。结果 发生组患者左心室收缩
期末内径(LVDs)大于未发生组和对照组,而左心室射血分数(LVEF)则小于未发生组和对照组(P <0.05);发生组
和未发生组患者低密度脂蛋白胆固醇(LDL-C)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、N 末端B型脑钠
肽前体(NT-proBNP)、C反应蛋白(CRP)、白细胞计数(WBC)和中性粒细胞计数(NE)水平均高于对照组,且发生组患
者CK-MB、cTnI和NT-proBNP水平均高于未发生组(P <0.05);发生组和未发生组患者血清APN水平均低于对照
组,而内脂素则均高于对照组(P <0.05),发生组患者血清APN水平低于未发生组,而内脂素则高于未发生组(P <
0.05);Pearson相关分析显示,发生组患者后血清APN水平均与TC、LDL-C、CK-MB、cTnI、CRP和NE呈负相关(P
<0.05),而血清内脂素水平均与TC、LDL-C、CK-MB、cTnI、NT-proBNP、NE和LVDs呈正相关(P <0.05);ROC曲
线显示,当APN<13.67g/L,AMI患者PCI术后血清APN水平预测发生心力衰竭时,敏感度64.2%,特异度87.1%;
当内脂素>6.29mg/L,血清内脂素水平预测发生心力衰竭时,敏感度90.3%,特异度77.9%。结论 AMI患者PCI
术后血清APN水平降低,而内脂素水平升高,可作为预测PCI术后发生心力衰竭的指标。

关键词: 心肌梗死, 血管成形术,经腔,经皮冠状动脉, 脂联素, 心力衰竭,充血性

Abstract:

ObjectiveTo investigate the significance of adiponectin and visfatin joint monitoring in predicting heart failure after PCI in acute myocardial infarction. MethodsA total of 157 cases of AMI patients undergoing PCI were selected. According to whether heart failure happened after PCI, the patients were divided into occurrence group (n=62) and nonoccurrence group (n=95). Forty cases of healthy were selected as control group. The echocardiography and blood biochemical examination data of all subjects were collected. In all AMI patients after PCI the next day and the control group in medical examination day, the serum levels of visfatin and APN were detected by using automated enzymelinked fluorescence analyzer. ResultsThe LVDs in occurrence group was greater than that in nonoccurrence group and control group, while LVEF was less than that of nonoccurrence group and control group(P<0.05). LDLC, CKMB, cTnI, NTproBNP, CRP, WBC and NE in occurrence group and nonoccurrence group were higher than those in control group, and  CKMB, cTnI and NTproBNP in occurrence group were higher than those in nonoccurrence group(P<0.05). The levels of APN in occurrence group and nonoccurrence group were lower than that of control group, while the levels of visfatin were higher than that of control group(P<0.05), the level of APN in occurrence group was lower than that of nonoccurrence group, while the level of visfatin was higher than that of nonoccurrence group(P<0.05). Pearson correlation analysis showed that serum APN level in occurrence group was negatively correlated with TC, LDLC, CKMB, cTnI, CRP and NE (P<0.05), and serum visfatin level was positively correlated with  TC, LDLC, CKMB, cTnI, NTproBNP, NE and LVDs (P<0.05). ROC curve showed that  the serum APN level in AMI patients after PCI can predict the occurrence of heart failure APN<13.67  g/L,the sensitivity was 64.2%, specificity  87.1%. Visfatin>6.29  mg/L, serum visfatin level showed the  sensitivity  90.3%, specificity  77.9%. ConclusionThe serum level of APN in AMI patients after PCI was reduced, while visfatin was elevated. They could be as indicators to predict heart failure occurring after PCI.

Key words: myocardial infarction, angioplasty, transluminal, percutaneous coronary, adiponectin, visfatin, heart failure, congestive