【摘要】 目的探讨血清可溶性致癌抑制因子2(sST2)水平与急性ST段抬高型心肌梗死(STEMI)患者预后的关系。方法选取2016年6月～2017年6月于郑州市第七人民医院就诊并确诊的102例STEMI患者,采取酶联免疫吸附法(ELISA)测定患者血清sST2水平,根据基线sST2中位数水平分为高值组(n=54,血清sST2水平>56.68 ng/ml)和低值组(n=48,血清sST2水平≤56.68 ng/ml),分析两组患者的一般资料,随访30 d,观察两组心力衰竭和死亡事件发生情况,经Logistic回归分析,分析STEMI患者预后的相关因素。结果两组在收缩压、舒张压、Killip心功能分级≥Ⅱ级所占比例、高敏C反应蛋白(hs-CRP)、N末端脑钠肽原(NT-proBNP)、肌钙蛋白I、左室射血分数(LVEF)水平方面比较差异显著,组间比较差异存在统计学意义(P<0.05);两组在性别、年龄、吸烟史、既往史、心率、血清总胆固醇、肌酐、尿酸、冠状动脉病变方面比较差异无统计学意义(P>0.05);经Pearson相关性分析,血清sST2水平与收缩压、舒张压、LVEF呈负相关(P<0.05),与Killip心功能分级≥Ⅱ级、hs-CRP、NT-proBNP、肌钙蛋白I水平呈正相关(P<0.05);随访30 d,高值组不良事件发生率高于低值组(P<0.05);经Logistic回归分析,血清sST2(OR=1.806,95%CI:0.674～13.965,P<0.05)是STEMI患者不良预后的危险因素。结论 STEMI患者血清sST2水平升高,则提示不良预后的风险增加。更多还原

【Abstract】 Objective To investigate the relationship between level of serum soluble suppression of tumorigenicity 2(sST2) and prognosis in patients with acute ST-segment elevation myocardial infarction(STEMI). Methods STEMI patients(n=102) were chosen visited and diagnosed in the Seventh People’s Hospital of Zhengzhou City from June 2016 to June 2017. The level of serum sST2 was detected by using ELISA, and according to median baseline of baseline sST2 the patients were divided into high-value group(n=54, sST2>56.68 ng/ml) and low-value group(n=48, sST2≤56.68 ng/ml). The general data was analyzed, and all patients were followed up for 30 d for observing the incidence of heart failure and death events. The factors related to prognosis of STEMI patients were analyzed by using Logistic regression analysis. Results The difference in systolic blood pressure(SBP), diastolic blood pressure(DBP), percentage of patients with Killip class≥Ⅱ, hs-CRP, NT-proBNP, cardiac troponin I(cTnI) and LVEF had statistical significance between 2 groups(SBP). The difference in sex, age, smoking history, past medical history, heart rate, serum total cholesterol(TC), serum creatinine(SCr), blood uric acid(BUA) and coronary artery lesions had no statistical significance between 2 groups(P>0.05). The results of Pearson correlation analysis showed that serum sST2 level was negatively correlated to SBP, DBP and LVEF(P<0.05), and positively correlated to Killip class≥Ⅱ, hs-CRP, NT-proBNP and cTnI(P<0.05). The incidence of adverse events was higher in high-value group than that in low-value group(P<0.05) after followed up for 30 d. The results of Logistic regression analysis showed that serum sST2(OR=1.806, 95%CI: 0.674～13.965, P<0.05) was a risk factor of poor prognosis in STEMI patients. Conclusion The higher serum sST2 level indicates the risk of poor prognosis increases in STEMI patients.更多还原