血清ST2、SIRT1、NT-proBNP水平在评估急性心肌梗死患者PCI术后并发心力衰竭风险的临床价值OA
Clinical Value of Serum ST2,SIRT1,and NT-proBNP Levels in Evaluating the Risk of Heart Failure After Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction
目的 探讨血清生长刺激表达基因2蛋白(ST2)、沉默信息调节因子2相关酶1(SIRT1)、N末端B型钠尿肽前体(NT-proBNP)水平在评估急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后并发心力衰竭(HF)风险的临床价值.方法 回顾性选取2023年1月至2025年5月于聊城市第二人民医院进行PCI的AMI患者195例,根据术后次日Killip分级分为HF组(Killip≥Ⅱ级,36例)和非HF组(Killip<Ⅱ级,159例).比较两组一般临床资料;采用多因素Logistic回归分析AMI患者PCI术后发生HF的危险因素;采用ROC曲线评估术后次日血清ST2、SIRT1、NT-proBNP对AMI患者PCI术后HF的预测价值.结果 两组冠状动脉病变支数比例比较,差异有统计学意义(P<0.05).HF组ST2、NT-proBNP水平显著高于非HF组,左室射血分数、SIRT1水平显著低于非HF组(P<0.001).多因素Logistic回归分析显示,血清ST2、NT-proBNP为AMI患者PCI术后发生HF的独立危险因素(OR=1.133,95%CI:1.083～1.185,P<0.001;OR=1.202,95%CI:1.105～1.308,P<0.001),左室射血分数、血清SIRT1为AMI患者PCI术后发生HF的独立保护因素(OR=0.717,95%CI:0.635～0.809,P<0.001;OR=0.841,95%CI:0.785～0.901,P<0.001).ROC曲线评估显示,血清SIRT1预测AMI患者PCI术后HF的曲线下面积为0.881,优于ST2、NT-proBNP预测的0.860、0.868(P<0.05).结论 AMI患者PCI术后次日左室射血分数与血清SIRT1水平越低,或血清ST2、NT-proBNP水平越高,其HF发生风险也相对越高,建议临床加强对上述指标的关注,对具备此类高危因素的患者应积极采取干预措施.
Objective To investigate the clinical value of serum levels of growth stimulation expressed gene 2 protein(ST2),sirtuin 1(SIRT1),and N-terminal pro-B-type natriuretic peptide(NT-proBNP)in evaluating the risk of heart failure(HF)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 195 patients with AMI who underwent PCI at the Second People's Hospital of Liaocheng from January 2023 to May 2025 were retrospectively enrolled.According to the Killip classification on the second postoperative day,they were divided into the HF group(Killip class≥Ⅱ,n=36)and the non-HF group(Killip class<Ⅱ,n=159).General clinical data were compared between the two groups.Multivariate logistic regression analysis was used to analyze the risk factors for HF in AMI patients after PCI.Receiver operating characteristic(ROC)curves were applied to evaluate the predictive value of serum ST2,SIRT1 and NT-proBNP on the day after the operation for postoperative HF in AMI patients undergoing PCI.Results There were statistically significant differences in the proportion of coronary artery lesion vessels between the two groups(P<0.05).The levels of ST2 and NT-proBNP in the HF group were significantly higher than those in the non-HF group,while the left ventricular ejection fraction and SIRT1 level were significantly lower(P<0.001).Multivariate logistic regression analysis showed that serum ST2 and NT-proBNP were independent risk factors for HF in AMI patients after PCI(OR=1.133,95%CI:1.083-1.185,P<0.001;OR=1.202,95%CI:1.105-1.308,P<0.001),whereas left ventricular ejection fraction and serum SIRT1 were independent protective factors(OR=0.717,95%CI:0.635-0.809,P<0.001;OR=0.841,95%CI:0.785-0.901,P<0.001).ROC curve analysis revealed that the area under the curve of serum SIRT1 for predicting postoperative HF in AMI patients was 0.881,which was superior to 0.860 for ST2 and 0.868 for NT-proBNP(P<0.05).Conclusion The lower the left ventricular ejection fraction and serum SIRT1 level,or the higher the serum ST2 and NT-proBNP levels on the second day after PCI,the higher the risk of HF in patients with AMI.It is recommended to pay close attention to these indicators in clinical practice and actively take measures for patients with such high-risk factors.
常方圆;秦宪涛;许迎春;徐莎;冯泽瑞
聊城市第二人民医院心内科,山东 聊城 252600聊城市第二人民医院综合外科,山东 聊城 252600聊城市第二人民医院心内科,山东 聊城 252600聊城市第二人民医院心内科,山东 聊城 252600聊城市第二人民医院心内科,山东 聊城 252600
急性心肌梗死经皮冠状动脉介入心力衰竭ST2SIRT1NT-proBNP
acute myocardial infarctionpercutaneous coronary interventionheart failuregrowth stimulation expressed gene 2 proteinsilent information regulator 2 related enzyme 1N-terminal pro-B-type natriuretic peptide
《转化医学杂志》 2026 (6)
940-944,5
山东省医药卫生科技项目(202503010376)聊城市重点研发计划政策引导类项目(2024YD44)
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