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目的:探讨补体Cq1/肿瘤坏死因子相关蛋白1(CTRP1)表达水平与急性ST段抬高性心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗术(PCI)出院后1个月死亡的相关性。方法:连续入选行急诊PCI治疗的STEMI患者246例,分为死亡组(28例)和存活组(218例)。采用酶联免疫吸附法(ELISA)测定血清CTRP1水平。以随访期间死亡作为终点事件。采用ROC曲线和COX回归生存分析CTRP1对患者死亡的预测价值。结果:平均随访32d,与存活组相比较,死亡组CTRP1水平明显升高(P<0.001)。ROC曲线分析,CTRP1水平对急性STEMI患者急诊PCI术后的死亡具有预测价值,截点值为181.7ng/ml时,敏感性为90.4%,特异度为70.5%,患者被分为CTRP1水平高值组和CTRP1水平低值组。COX生存回归分析显示,CTRP1≥181.7ng/ml是患者死亡的独立危险因素之一(HR=3.46,95%CI:1.67~7.07 P=0.001)。结论:CTRP1水平与急诊PCI后急性STEMI患者预后有相关性,CTRP1≥181.7ng/ml可作为急性STEMI患者急诊PCI术后死亡的独立预测因素,并对患者进行危险分层。
Objective: To investigate the relationship between the expression of complement Cq1 / tumor necrosis factor-related protein 1 (CTRP1) and the death of patients with acute ST-elevation myocardial infarction (STEMI) one month after hospital discharge after emergency percutaneous coronary intervention (PCI) . Methods: A total of 246 STEMI patients undergoing emergency PCI were enrolled in this study. They were divided into death group (n = 28) and survival group (n = 218). Serum CTRP1 levels were determined by enzyme-linked immunosorbent assay (ELISA). Follow-up deaths as the end point. Using ROC curve and COX regression to predict the prognosis of patients with CTRP1. Results: After a mean follow-up of 32 days, the CTRP1 level in the death group was significantly higher than that in the surviving group (P <0.001). ROC curve analysis showed that the CTRP1 level had predictive value for emergency post-PCI mortality in patients with acute STEMI. The cut-off value was 181.7ng / ml with a sensitivity of 90.4% and a specificity of 70.5%. The patients were divided into high CTRP1 Group and CTRP1 low level group. COX survival regression analysis showed that CTRP1≥181.7 ng / ml was one of the independent risk factors for death (HR = 3.46, 95% CI: 1.67-7.07 P = 0.001). Conclusions: The CTRP1 level correlates with the prognosis of patients with acute STEMI after emergency PCI. CTRP1 ≥ 181.7 ng / ml may be used as an independent predictor of post-PCI mortality in patients with acute STEMI and risk stratification.