sST2联合Galectin-3在急性心肌梗死PCI术后心衰中的预测价值

李小溪; 储岳峰; 朱杰; 王中群

sST2联合Galectin-3在急性心肌梗死PCI术后心衰中的预测价值

Predictive value of sST2 combined with Galectin-3 for heart failure after PCI in acute myocardial infarction

摘要

摘要:
目的： 探究血清可溶性生长刺激表达基因2蛋白（sST2）、半乳糖凝集素3（Galectin-3）对急性心肌梗死（AMI）行经皮冠状动脉介入治疗（PCI）后并发心力衰竭（HF）的预测价值。
方法： 选取确诊AMI并在72h内成功接受PCI术的病人58例，根据术后1周内是否并发心力衰竭，分为心梗后心衰（AMI-HF）组24例和心梗后未发生心衰（AMI）组34例，同时选取住院期间行冠状动脉造影检查为阴性的受试者25例作为对照组，对各组血清sST2、Galectin-3水平进行测定。比较3组一般资料、心室重构指标、脑钠肽（BNP）、肌酸激酶同工酶（CKMB）、sST2、Galectin-3的水平，运用Pearson相关性分析研究AMI-HF组病人sST2、Galectin-3水平和BNP之间的相关性。采用二元Logistic回归逐步分析AMI后HF的独立危险因素。运用ROC曲线分析血清sST2和Galectin-3水平对病人发生AMI后HF的预测价值。
结果： 3组间血清sST2、Galectin-3水平差异均具有统计学意义（P ＜ 0.01）。AMI-HF组病人的血清sST2、Galectin-3水平与BNP均呈正相关（r = 0.644、r = 0.774，P ＜ 0.01）。Logistic分析结果提示，sST2、Galectin-3均是AMI后HF的独立预测因素（OR = 1.469，95%CI：1.067～2.023，P ＜ 0.05；OR = 1.540，95%CI：1.059～2.238，P ＜ 0.05）。ROC分析结果显示，血清sST2、Galectin-3联合预测较单一指标预测AMI后HF的效能更大。
结论： 血清sST2、Galectin-3水平是AMI后HF的独立危险因素，具有较好的预测价值，可为临床工作提供参考。

Abstract:
Objective To investigate the predictive value of serum soluble growth stimulating gene 2 protein (sST2) and galectin-3 for heart failure (HF) after percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI).
Method 58 patients diagnosed with AMI and successfully underwent PCI within 72 hours were selected. According to whether they developed heart failure within one week after surgery, they were divided into a post myocardial infarction heart failure (AMI-HF) group of 24 cases and a post myocardial infarction heart failure (AMI) group of 34 cases. At the same time, 25 subjects who tested negative for coronary angiography during hospitalization were selected as the control group, and serum sST2 and Galectin-3 levels were measured in each group. Compare the general clinical data, ventricular remodeling indicators, brain natriuretic peptide (BNP), creatine kinase-MB (CK-MB), sST2, and Galectin-3 levels among the three groups, and use Pearson correlation analysis to investigate the relationship between sST2, Galectin-3, and BNP levels in patients with acute myocardial infarction and heart failure (AMI-HF).Use binary logistic regression to gradually analyze independent risk factors for HF after AMI. Using ROC curve analysis to assess the predictive value of serum sST2 and Galectin-3 levels for HF in patients with AMI.
Result The differences in serum sST2 and Galectin-3 levels among the three groups were statistically significant (P ＜ 0.01). The serum levels of sST2 and Galectin-3 in the AMI-HF group were positively correlated with BNP (r = 0.644, r = 0.774, P ＜ 0.01). The logistic analysis results indicate that sST2 and Galectin-3 are independent predictive factors for HF after AMI (OR = 1.469, 95%CI: 1.067–2.023, P ＜ 0.05; OR = 1.540, 95%CI: 1.059–2.238, P ＜ 0.05). The ROC analysis results showed that the combined prediction of serum sST2 and Galectin-3 was more effective in predicting HF after AMI compared to a single indicator.
Conclusions Serum sST2 and Galectin-3 levels are independent risk factors for heart failure after acute myocardial infarction (AMI), which has good predictive value and provide a useful reference for clinical practice.

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