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目的探讨血浆长正五聚蛋白3(PTX3)对ST段抬高型心肌梗死(STEMI)近期不良心血管事件的预测价值。方法连续入选84例急性ST段抬高型心肌梗死患者,根据血浆PTX3的三分位数水平,将研究对象分为三组:低PTX3水平组(A组,PTX3<2.53,n=28),中PTX3水平组(B组,2.53≤PTX3<6.90,n=25),高PTX3水平组(C组,PTX3≥6.90,n=31)。用OLYMPUS全自动生化仪检测患者的甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、肌钙蛋白I(cTnI)及N-末端B型利钠肽前体(NT-proBNP)水平。随访并记录84例患者近3个月内是否再发主要不良心血管事件(非致死性心肌梗死、非致死性心力衰竭、心源性死亡),用Logistic回归分析PTX3水平对STEMI患者近期发生主要不良心血管事件的预测价值。结果患者发生各主要不良心血管事件的概率随着PTX3水平的升高而增加,三组患者发生复合事件的概率差异有统计学意义(χ~2=8.05,P=0.02)。PTX3预测STEMI患者3个月内发生复合事件的ROC曲线下面积为0.82,与cTnI、NT-proBNP相比,PTX3具有较高的敏感度(0.846),但特异度较低(0.786)。B、C组近3个月内发生主要不良心血管事件的风险分别是A组的3.17倍、8.31倍,且在校正cTnI、NT-proBNP后,其风险值分别为1.82倍、3.64倍,差异均有统计学意义(P<0.01)。结论 PTX3水平可作为STEMI患者近期发生主要不良心血管事件的独立危险因素。
Objective To investigate the predictive value of long placental pentraxin 3 (PTX3) in the treatment of recent adverse cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI). Methods Eighty-four patients with acute ST-segment elevation myocardial infarction were enrolled in this study. Subjects were divided into three groups according to the level of plasma PTX3: low PTX3 (group A, PTX3 <2.53, n = 28) PTX3 level group (group B, 2.53≤PTX3 <6.90, n = 25), high PTX3 level group (group C, PTX3≥6.90, n = 31). The triglyceride (TG), cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), troponin I (cTnI) and N-terminal B Natriuretic peptide precursor (NT-proBNP) levels. Follow-up and record of 84 patients with major adverse cardiovascular events (non-fatal myocardial infarction, non-fatal heart failure, cardiac death) within the past 3 months, using Logistic regression analysis of PTX3 levels in patients with STEMI recent major Predictors of adverse cardiovascular events. Results The probability of occurrence of major adverse cardiovascular events increased with the increase of PTX3 level. There was a statistically significant difference in the probability of occurrence of composite events between the three groups (χ ~ 2 = 8.05, P = 0.02). The area under the ROC curve for PTX3-predicted composite events within 3 months in STEMI patients was 0.82. PTX3 had a higher sensitivity (0.846) but a lower specificity (0.786) than cTnI and NT-proBNP. The risk of major adverse cardiovascular events in group B and C within 3 months were 3.17 and 8.31 times respectively in group A, and the risk of cTnI and NT-proBNP after correction was 1.82 and 3.64 times, respectively All were statistically significant (P <0.01). Conclusions PTX3 level can be used as an independent risk factor for major adverse cardiovascular events in STEMI patients.