目的 探讨血清血管生成素 2(angiopoietin-2,Ang-2)、肠脂肪酸结合蛋白(intestinal fatty acid binding protein,I-FABP)水平与急性心肌梗死(acute myocardial infarction,AMI)合并心源性休克(cardiac shock,CS)预后的相关性.方法 选取 2017 年 7 月至 2019 年 7 月湖州市中心医院收治的AMI患者 198 例为研究对象,根据住院期间是否并发CS,将其分为CS组(n=93)和无CS组(n=105),另选取同期入院体检的正常志愿者 65 人纳入对照组,根据 28d的生存情况将CS组患者分为生存组(n=50)和死亡组(n=43).检测所有受试者的血清Ang-2、I-FABP水平,采用Cox回归分析影响AMI合并CS患者不良预后的因素;受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析Ang-2、I-FABP对AMI合并CS患者预后不良的诊断价值.结果 CS组患者的血清Ang-2、I-FABP水平均显著高于无CS组和对照组(P<0.05),无CS组患者的血清Ang-2、I-FABP水平显著高于对照组(P<0.05).死亡组患者的血清Ang-2、I-FABP水平和糖尿病比例均显著高于生存组(P<0.05).Cox回归分析结果显示,糖尿病、Ang-2、I-FABP水平均为影响AMI合并CS患者预后的独立因素(P<0.05).ROC曲线显示,Ang-2 和I-FABP联合预测AMI合并CS患者预后的曲线下面积为 0.819,敏感度 81.4%,特异性 80.0%.结论 AMI合并CS患者的血清Ang-2、I-FABP水平升高,且是预测患者预后的潜在生物学指标.
Objective To investigate the correlation between angiopoietin-2(Ang-2)and intestinal fatty acid binding protein(I-FABP)levels and the prognosis of acute myocardial infarction(AMI)with cardiac shock(CS).Methods A total of 198 patients with AMI admitted to Huzhou Central Hospital from July 2017 to July 2019 were selected as study objects,and were divided into CS group(n=93)and non-CS group(n=105)according to whether CS occurred during the hospital period,and 65 normal volunteers admitted for physical examination during the same period were included in control group.Patients in CS group were divided into survival group(n=50)and death group(n=43)according to their survival at 28 days.Serum Ang-2 and I-FABP levels of all subjects were detected,and Cox regression analysis was used to analyze the factors affecting the poor prognosis of AMI with CS.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of Ang-2 and I-FABP in AMI with CS.Results Serum Ang-2 and I-FABP levels in CS group were significantly higher than those in non-CS group and control group(P<0.05),and serum Ang-2 and I-FABP levels in non-CS group were significantly higher than those in control group(P<0.05).Serum Ang-2,I-FABP levels and proportion of diabetes in death group were significantly higher than those in survival group(P<0.05).Cox regression analysis showed that diabetes,Ang-2 and I-FABP levels were independent factors affecting the prognosis of AMI with CS(P<0.05).ROC curve showed that the area under the curve of Ang-2 and I-FABP combined to predict the prognosis of AMI with CS was 0.819,sensitivity was 81.4%,specificity was 80.0%.Conclusion Serum Ang-2 and I-FABP levels were elevated in patients with AMI with CS,which were potential biological indicators to predict the prognosis of patients.
王东;许岚;夏森林;孙越晨;王伟
浙江大学医学院附属湖州医院(湖州市中心医院)急诊科,浙江湖州 313000
临床医学
急性心肌梗死;心源性休克;血管生成素2;肠脂肪酸结合蛋白;预后
Acute myocardial infarction;Cardiac shock;Angiopoietin-2;Intestinal fatty acid binding protein;Prognosis
《中国现代医生》 2024 (001)
32-35 / 4
浙江省湖州市科学技术局公益性应用研究项目(2019GYB13)
10.3969/j.issn.1673-9701.2024.01.008
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