摘要
目的分析外周血脂质运载蛋白2(Lipocalin 2,LCN2)水平与急性心肌梗死(Acute Myocardial Infarction,AMI)患者左心室重构(Left ventricle Remodel,LVR)的关系。方法回顾性分析2015年1月—2018年1月在周口市人民医院接受急诊PCI手术的149例AMI患者的临床资料,按是否发生LVR分LVR组、对照组,比较两组一般临床资料及外周血LCN2水平,logistic回归分析AMI患者发生LVR的危险因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析外周血LCN2水平对AMI患者LVR的预测价值。结果 149例患者中,98例LVR,将其纳入LVR组,另51例纳入对照组,LVR组血清肌酐、肌钙蛋白(Cardiac troponin I,cTnI)峰值、脑钠肽(brain natriuretic factor of peptide,BNP)、LCN2均显著高于对照组,以LVR为因变量,血清肌酐、CTnI峰值、BNP、LCN2为协变量行多因素logistic回归分析,CTnI峰值、BNP、LCN2均是心AMI患者LVR的独立危险因素(P<0.01);LCN2预测LVR的曲线下面积值最佳,为0.972,cut-off为285.816 pg/mL,敏感度为99.00%、特异度为87.80%,其次为CTnI峰值,cut-off为3.758μg/L,敏感度为75.50%、特异度为87.80%;肌酐、BNP曲线下面积指<0.6,提示预测效能不佳。结论 AMI患者外周血LCN2水平或为AMI患者左心室重构的独立危险因素之一,可对AMI患者左心室重构发挥一定预测价值,值得临床重视。
Objective To analyze the relationship between peripheral blood lipocalin 2(LCN2) level and left ventricular remodeling(LVR) in patients with acute myocardial infarction(AMI).Methods The clinical data of 149 patients with AMI who underwent emergency PCI in the hospital from January 2015 to January 2018 were retrospectively analyzed. According to whether data and peripheral blood LCN2 level were compared between the two groups, and logistic regression analysis was used to analyze the risk factors of LVR in AMI patients, and the receiver operating characteristic(ROC) curve was used to analyze the predictive value of peripheral blood LCN2 level on LVR in AMI patients.Results Among the 149 patients, there were 98 cases of LVR were included in LVR group, and another 51 cases were included in control group, and the levels of serum creatinine, cardiac troponin I(cTnI) peak, brain natriuretic factor of peptide(BNP) and LCN2 in LVR group were significantly higher than those in control group(P<0.05). Multivariate logistic regression analysis was performed by taking LVR as dependent variable and serum creatinine, cTnI peak, BNP and LCN2 as concomitant variables, and cTnI peak, BNP and LCN2 were independent risk factors for LVR in AMI patients(P<0.01). The area under the curve of LCN2 in predicting LVR was the best with 0.972, and the cut-off value, sensitivity and specificity were 285.816 pg/mL, 99.00% and 87.80%, and the second area under the curve was CTnI peak, and its cut-off value, sensitivity and specificity were 3.758 μg/L, 75.50% and 87.80%. The values of area under curve of creatinine and BNP both were <0.6, indicating that the prediction efficacy was poor.Conclusion Peripheral blood LCN2 level in AMI patients may be one of the independent risk factors for left ventricular remodeling in patients with AMI, and it may play a certain predictive value on left ventricular remodeling in patients with AMI, thus it is worthy of clinical attention.
作者
安慧
陈雪冰
马素华
AN Hui;CHEN Bing-xue;MA Su-hua(Deartment of Vasculocardiology,Zhoukou People's Hospital,Zhoukou,Henan 466000,China)
出处
《医药论坛杂志》
2021年第2期51-54,58,共5页
Journal of Medical Forum
关键词
脂质运载蛋白2
急性心肌梗死
左心室重构
Lipocalin 2
Acute myocardial infarction
Left ventricular remodeling
