血清NT-proBNP、hs-cTnI、CysC与急性心肌梗死PCI术后发生心力衰竭相关性

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摘要 目的: 探讨血清N-端脑利钠肽前体（NT-proBNP）、超敏肌钙蛋白（hs-cTnI）、胱抑素C（CysC）与急性心肌梗死（AMI）经皮冠状动脉介入治疗（PCI）后发生HF的相关性。方法: 选取2020年1月―2022年1月广安市人民医院行PCI术治疗的154例AMI患者（AMI组）,根据PCI术后6个月HF发生情况将其分为HF组28例和非HF组126例,另选取同期77例健康体检者（HC组）。比较AMI组和HC组血清NT-proBNP、hs-cTnI、CysC水平;比较AMI患者PCI术后HF组与非HF组临床特征及三种血清指标水平;Pearson相关性分析AMI患者PCI术后HF组血清NT-proBNP、hs-cTnI、CysC水平的关系;Logistic回归分析影响AMI患者PCI术后并发HF的相关危险因素;ROC分析血清NT-proBNP、hs-cTnI、CysC与AMI患者PCI术后发生HF的诊断价值。结果: AMI组血清NT-proBNP、hs-cTnI、CysC水平高于HC组;HF组与非HF组年龄、发病至入院时间、冠脉病变支数、Gensini评分、LVEF、Tei指数和CK-MB水平差异显著;HF组三种血清指标水平高于非HF组;Pearson相关性分析,HF组血清NT-proBNP、hs-cTnI、CysC水平间呈正相关;Logistic回归分析,年龄、Gensini评分和上述三种血清指标水平为影响PCI术后并发HF的因素;ROC分析,血清NT-proBNP、hs-cTnI、CysC水平诊断AMI患者PCI术后HF的AUC分别为0.878、0.732和0.710,联合诊断AMI患者PCI术后HF的AUC为0.889,灵敏度、特异度分别为94.74%和75.76%。结论: 血清NT-proBNP、hs-cTnI、CysC水平与AMI患者PCI术后发生HF存在密切的相关性,且各指标间存在正相关。

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	杨红祥
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关键词 ： N-端脑利钠肽前体, 高敏肌钙蛋白, 胱抑素C, 急性心肌梗死, 心力衰竭

Abstract：Objective To explore the correlation between serum N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive cardiac troponin (hs-cTnI), cystatin C (CysC) and heart failure (HF) in acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods A total of 154 patients with AMI undergoing PCI in Guang’an People's Hospital were enrolled as AMI group between January 2020 and January 2022. According to presence or absence of HF at 6 months after PCI, they were divided into HF group (28 cases) and non-HF group (126 cases). A total of 77 healthy controls (HC) during the same period were enrolled as HC group. The levels of serum NT-proBNP, hs-cTnI and CysC between AMI group and HC group, as well as the clinical characteristics and levels of serum NT-proBNP, hs-cTnI and CysC between HF group and non-HF group were compared. The relationship among serum NT-proBNP, hs-cTnI and CysC was analyzed by Pearson correlation analysis. The risk factors of HF were analyzed by Logistic regression analysis. The diagnostic value of NT-proBNP, hs-cTnI and CysC for HF was analyzed by receiver operating characteristic (ROC) curves. Results The levels of serum NT-proBNP, hs-cTnI and CysC in AMI group were higher than those in HC group. There were significant differences in age, interval from onset to admission, number of coronary lesions, Gensini score, LVEF, Tei index and CK-MB between HF group and non-HF group. The levels of serum NT-proBNP, hs-cTnI and CysC in HF group were higher than those in non-HF group. Pearson correlation analysis showed that levels of serum NT-proBNP, hs-cTn and CysC were positively correlated. Logistic regression analysis showed that age, Gensini score, NT-proBNP, hs-cTnI and CysC were all influencing factors of HF. ROC curves analysis showed that AUC values of serum NT-proBNP, hs-cTnI and CysC in the diagnosis of HF were 0.878, 0.732 and 0.710, respectively. AUC, sensitivity and specificity of combined detection were 0.889, 94.74% and 75.76%, respectively. Conclusion The levels of serum NT-proBNP, hs-cTnI and CysC are closely related to HF in AMI patients after PCI, and the three indexes are correlated.

Key words： N-terminal pro-brain natriuretic peptide high-sensitive cardiac troponin cystatin C acute myocardial infarction heart failure

收稿日期: 2022-12-08

中图分类号:

R541.4

基金资助:四川省转移支付项目（2021ZYZFSY01）

通讯作者: 颜红梅,E-mail：1043329484@qq.com

引用本文:

杨红祥, 颜红梅, 文俊杰. 血清NT-proBNP、hs-cTnI、CysC与急性心肌梗死PCI术后发生心力衰竭相关性[J]. 湖南师范大学学报(医学版), 2023, 20(1): 80-84. YANG Hongxiang, YAN Hongmei, WEN Junjie. Correlation between serum NT-proBNP, hs-cTnI, CysC and heart failure in acute myocardial infarction after PCI. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(1): 80-84.

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http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2023/V20/I1/80

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