摘要
目的探讨血清剪切型X-盒结合蛋白1(XBP-1S)水平与急性心肌梗死(AMI)急诊经皮冠状动脉介入治疗(PCI)后发生心肌灌注损伤的关系。方法回顾性分析2018年1月至2020年1月期间本院急诊接受PCI治疗的150例AMI患者病历资料,依据PCI 6 h后是否发生心肌灌注损伤,将入选者分为发生组与未发生组,比较两组一般资料及检测实验室指标,重点分析PCI治疗前血清XBP-1S水水平与患者心肌灌注损伤的关系。结果全部150例AMI患者,经PCI治疗6h后,发生心肌灌注损伤69例,发生率为46.00%;发生组血清MPO[93.27(87.23,103.72)AUU/L]和XBP-1S[180.03(157.44,203.01)pg/ml]水平均高于未发生组[81.30(75.55,86.25)AUU/L]和[148.31(139.28,162.25)pg/ml],差异有统计学意义(U=7.136、6.846;P均<0.001);组间其他资料比较,差异无统计学意义(P>0.05)。Logistic回归分析结果显示,治疗前血清MPO和XBP-1S水平与AMI患者经PCI治疗后发生心肌灌注损伤有关,各指标过表达可能是AMI患者经PCI治疗后发生心肌灌注损伤的风险因子(OR>1,P<0.05)。ROC曲线结果显示,治疗前血清髓过氧化物酶MPO和剪切型X-盒结合蛋白1(XBP-1S)水平单独及联合预测AMI患者经PCI治疗后发生心肌灌注损伤风险的曲线下面积(AUC)>0.80,预测价值较理想,且以治疗前血清MPO和XBP-1S的cut-off值分别为85.980 AUU/L和159.023 pg/ml时,预测价值最佳。结论 AMI患者PCI前血清XBP-1S水平与PCI后心肌灌注损伤有关,可能是患者经PCI治疗后发生心肌灌注损伤的风险因子,对预测患者心肌灌注损伤发生风险有一定价值。
Objective To evaluate the relationship between the serum shear type X-box binding protein 1(XBP-1 S) level and myocardial perfusion injury after emergency percutaneous coronary intervention(PCI) for acute myocardial infarction(AMI). Methods The data of the 50 patients with AMI who received emergency PCI treatment in our hospital from January 2020 to January 2020 were selected;according to whether myocardial perfusion injury occurred 6 hours after PCI, the patients were divided into the occurrence group and the non occurrence group. The general data and the laboratory indexes between the two groups were compared and the relationship between serum XBP-1 S level and myocardial perfusion injury in the patients before PCI treatment was focally analyzed. Results In all 150 AMI patients after 6 hours of PCI treatment, 69 cases had myocardial perfusion injury and the incidence was 46.00%;the levels of MPO [93.27(87.23, 103.72) AUU/L] and XBP-1 S[180.03(157.44, 203.01) pg/ml] in the occurrence group were higher than the non occurrence group [81.30(75.55,86.25) AUU/L and 148.31(139.28, 162.25) pg/ml], with a statistical significant difference(U=7.136, 6.846;all P<0.001);compared the other data between 2 groups, there was no statistical significant difference(P>0.05). The results of logistic regression analysis showed that the levels of MPO and XBP-1 S before treatment were related to the myocardial perfusion injury in AMI patients after PCI treatment and the overexpression of each index might be the risk factor of myocardial perfusion injury in AMI patients after PCI treatment(OR>1, P<0.05). ROC curve showed that the area under the curve(AUC) of serum MPO and XBP-1 S levels alone or in combination predicting the risk of myocardial perfusion injury in AMI patients after PCI treatment were >0.80 and the predictive value was more ideal;when the cut off values of MPO and XBP-1 S before treatment were 85.980 AUU/L and 159.023 pg/ml respectively, the predictive value was the best. Conclusion The serum XBP-1 S level before PCI treatment is related to the myocardial perfusion injury in AMI patients after PCI treatment, which may be a risk factor for the injury and have certain value in predicting the risk.
作者
符超
王日兴
林芳崇
FU Chao;WANG Ri-xing;LIN Fang-chong(Department of Emergency,Second Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570311,China)
出处
《中国心血管病研究》
CAS
2021年第9期824-828,共5页
Chinese Journal of Cardiovascular Research
基金
海南省卫生计生行业科研项目(20A2000375)。
关键词
急性心肌梗死
经皮冠状动脉介入治疗
心肌灌注损伤
剪切型X-盒结合蛋白1
相关性
Acute myocardial infarction
Percutaneous coronary intervention
Myocardial perfusion injury
Shear type X-box binding protein 1
Correlation
