血清AGP、EREG联合心电图对急性心肌梗死病人介入治疗后发生MACE的预测价值

杨学燕; 权慧娟; 郑云沙; 权慧芃; 朱国英; 郭志谦; 李娜; 王静

血清AGP、EREG联合心电图对急性心肌梗死病人介入治疗后发生MACE的预测价值

The predictive value of serum AGP, EREG combined with electrocardiogram for MACE in patients with acute myocardial infarction after interventional therapy

摘要

摘要:
目的： 探讨血清α1酸性糖蛋白（AGP）、表皮调节素（EREG）联合心电图对急性心肌梗死（AMI）病人经皮冠状动脉介入术（PCI）后发生主要不良心血管事件（MACE）的预测价值。
方法： 选取187例急性ST段抬高型心肌梗死（STEMI）病人为研究对象，根据STEMI病人PCI后6个月内是否发生MACE分为未发生MACE组（n = 135）和MACE组（n = 52）。比较2组血清AGP、EREG水平；分析血清AGP、EREG、心电图及三者联合预测STEMI病人PCI后发生MACE的价值。
结果： MACE组STEMI病人血清AGP和EREG水平均高于未发生MACE组的水平（P ＜ 0.01）；血清AGP、EREG预测STEMI病人PCI后发生MACE的曲线下面积（AUC）分别为0.863、0.867，灵敏度分别为88.46%、86.54%，特异度分别为75.56%、77.04%，准确度分别为79.14%、79.68%；心电图T波倒置、早期ST段回落＜50%预测STEMI病人PCI后发生MACE的灵敏度分别为69.23%、90.38%，特异度分别为66.67%、74.07%，准确度分别为67.38%、78.61%；血清AGP、EREG、心电图早期ST段回落＜50%联合预测STEMI病人PCI后发生MACE的灵敏度为86.54%，特异度为97.78%，准确度为94.65%，特异度和准确度均高于单项指标的特异度和准确度（P ＜ 0.01）。
结论： 血清AGP、EREG联合心电图对STEMI病人PCI后发生MACE的预测价值较高，可能是临床判定STEMI病人PCI后是否发生MACE参考方案。

Abstract:
Objective To explore the predictive value of serum α1-acid glycoprotein (AGP), epidermal modulin (EREG) combined with electrocardiogram for major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).
Methods A total of 187 patients with acute ST-segment elevation myocardial infarction (STEMI) were selected as the research subjects. According to whether MACE occurred within 6 months after PCI, the STEMI patients were divided into the non-MACE group (n = 135) and MACE group (n = 52). The levels of serum AGP and EREG were compared between two groups. The value of serum AGP, EREG, electrocardiogram and combination of the three in predicting MACE in STEMI patients after PCI were analyzed.
Results The levels of serum AGP and EREG in STEMI patients of the MACE group were both higher than those in the group without MACE (P ＜ 0.01). The area under the curve (AUC) of serum AGP and EREG for predicting MACE in STEMI patients after PCI was 0.863 and 0.867, respectively. The sensitivities were 88.46% and 86.54%, respectively. The specificities were 75.56% and 77.04%, respectively. The accuracies were 79.14% and 79.68%, respectively. The sensitivities of electrocardiogram T wave inversion and early ST segment regression ＜ 50% for predicting MACE in STEMI patients after PCI were 69.23% and 90.38% respectively, the specificities were 66.67% and 74.07% respectively, and the accuracies were 67.38% and 78.61% respectively. The combined sensitivity of serum AGP, EREG and early ST-segment regression of electrocardiogram ＜ 50% in predicting MACE in STEMI patients after PCI was 86.54%, the specificity was 97.78%, and the accuracy was 94.65%. Both the specificity and accuracy were higher than those of individual indicators (P ＜ 0.01).
Conclusions Serum AGP, EREG combined with electrocardiogram have a relatively high predictive value for the occurrence of MACE in STEMI patients after PCI, and may be a reference protocol for clinical determination of whether MACE occurs in STEMI patients after PCI.

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