摘要
目的探讨血清分泌型卷曲相关蛋白1(SFRP1)、颗粒蛋白前体(PGRN)对急性心肌梗死患者(AMI)经皮冠状动脉介入治疗(PCI)术后在院转归的预测价值。方法选取2022年2月至2025年1月唐山中心医院收治的202例接受PCI治疗的AMI患者作为研究对象,收集患者临床资料及血清SFRP1、PGRN水平。根据患者PCI术后在院期间预后转归情况分为预后良好组(162例)与预后不良组(40例)。绘制受试者工作特征曲线分析血清SFRP1、PGRN及二者联合预测AMI患者PCI术后在院转归的价值;采用多因素Logistic逐步回归分析探讨AMI患者PCI术后在院转归的独立影响因素。结果预后不良组患者血清SFRP1水平显著低于预后良好组,PGRN水平显著高于预后良好组(均P<0.05)。血清SFRP1、PGRN及二者联合(串联)预测AMI患者在院转归的曲线下面积(95%CI)分别为0.819(0.774~0.869)、0.736(0.686~0.786)、0.904(0.859~0.954),二者联合的曲线下面积显著高于SFRP1(Z=4.043,P<0.001)、PGRN(Z=3.102,P<0.001)单独预测。预后不良组患者低密度脂蛋白胆固醇、心肌肌钙蛋白Ⅰ水平和多支血管病变患者占比显著高于预后良好组,左室射血分数显著低于预后良好组(P<0.05)。多因素分析结果显示,心肌肌钙蛋白Ⅰ高水平(OR=2.230,95%CI:1.175~4.233)、存在多支血管病变(OR=2.094,95%CI:1.052~4.166)、血清SFRP1≤12.60 ng/mL(OR=3.511,95%CI:1.935~6.372)、血清PGRN≥251.46 pg/mL(OR=2.824,95%CI:1.634~4.879)是AMI患者PCI术后在院转归的独立危险因素(P<0.05)。结论AMI患者PCI术后血清SFRP1水平降低及PGRN水平升高与在院转归预后不良密切相关,二者联合检测对预测在院转归具有较好价值。
Objective To explore the predictive value of serum secreted frizzled-related protein 1(SFRP1)and progranulin(PGRN)for in-hospital outcomes after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods A total of 202 AMI patients who underwent PCI in Tangshan Central Hospital from February 2022 to January 2025 were selected.Clinical data and serum levels of SFRP1 and PGRN were collected.According to the in-hospital prognosis after PCI,patients were divided into a good prognosis group(n=162)and a poor prognosis group(n=40).The receiver operating characteristic curve was used to analyze the value of serum SFRP1,PGRN and their combination in predicting inhospital outcomes after PCI in AMI patients.Multivariate logistic stepwise regression analysis was used to explore independent influencing factors for in-hospital outcomes after PCI in AMI patients.Results Serum SFRP1 level was significantly lower,and the PGRN level was significantly higher in the poor prognosis group than in the good prognosis group(both P<0.05).The areas under the curve(AUC)(95%CI)of serum SFRP1,PGRN and their combination(in series)for predicting in-hospital outcomes were 0.819(0.774–0.869),0.736(0.686–0.786),and 0.904(0.859–0.954),respectively.The AUC of the combined prediction was significantly higher than that of SFRP1 alone(Z=4.043,P<0.001)and PGRN alone(Z=3.102,P<0.001).Levels of lowdensity lipoprotein cholesterol and cardiac troponin I(cTnI),as well as the proportion of patients with multi-vessel disease,were significantly higher in the poor prognosis group,while left ventricular ejection fraction was significantly lower than in the good prognosis group(P<0.05).Multivariate analysis showed that high cTnI level(OR=2.230,95%CI:1.175–4.233),presence of multi-vessel disease(OR=2.094,95%CI:1.052–4.166),serum SFRP1≤12.60 ng/mL(OR=3.511,95%CI:1.935–6.372),and serum PGRN≥251.46 pg/mL(OR=2.824,95%CI:1.634–4.879)were independent risk factors for in-hospital outcomes after PCI in AMI patients(P<0.05).Conclusion Decreased serum SFRP1 level and increased PGRN level in AMI patients after PCI are closely related to poor in-hospital outcomes.Combined detection has good predictive value for in-hospital outcomes.
作者
袁百祥
徐晶晶
刘晓腾
战洋
YUAN Baixiang;XU Jingjing;LIU Xiaoteng;ZHAN Yang(Department of Cardiovascular Medicine,Tangshan Central Hospital,Tangshan,Hebei 063000,China)
出处
《转化医学杂志》
2026年第3期425-430,共6页
Translational Medicine Journal
基金
河北省2024年度医学科学研究课题计划项目(20240122)。
