关键词: 心肌梗死, 甲壳质酶蛋白40, 趋化因子配体18, 高敏心肌肌钙蛋白, 心血管不良事件

Abstract: Objective  To observe the clinical value of serum chitinase protein (YKL)40, CCchemokine ligand 18 (CCL18) and highsensitivity cardiac troponin (hscTnT) in predicting adverse  cardiovascular events in patients with acute myocardial infarction(AMI). Methods  Totally 118 patients with AMI from January 2016 to June 2018 were selected in our hospital. The serum YKL40, CCL18 and hscTnT were detected by enzymelinked immunosorbent assay. The relationship among the serum YKL40, CCL18 and hscTnT levels in patients with AMI, the degree of coronary artery stenosis and adverse events were also observed. Results  The serum YKL40, CCL18 and hscTnT levels in AMI patients rose with the increase of Gensini score.  And the serum YKL40, CCL18 and hscTnT levels in event group were significantly higher than those in nonevent  group (P<0.01). The levels of serum YKL40, CCL18 and hscTnT in patients with AMI were independent risk factors for major adverse events, and had higher sensitivity and specificity in predicting major adverse events. The combined detection in predicting major adverse events in patients with AMI had a higher diagnostic efficacy, with a sensitivity of 89.2% and a specificity of 86.4%, and the area under the curve (ACU) was significantly higher than that measured by the detection of  YKL40 (Z=3.397, P<0.01), CCL18 (Z=2.796, P<0.01), and hscTnT (Z=2.613, P<0.01),  respectively. Conclusion  The serum YKL40, CCL18 and hscTnT are indicators reflecting the severity of AMI, and have predictive effects on the occurrence of adverse events in AMI.

Key words: myocardial infarction, Chitinase protein40, chemokine ligand 18, highsensitivity cardiac troponin, adverse cardiovascular events