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目的 :探讨髓过氧化物酶(MPO)在急性心肌梗死患者(AMI)经皮冠状动脉介入治疗(PCI)后的动态变化及对患者不良心血管事件(MACE)发生的预测价值。方法 :选取本院心血管内科2013年1月~2015年1月采用PCI治疗的127例AMI患者进行回顾性分析,根据患者术后是否发生不良心血管事件(MACE)分为MACE组43例、非MACE组84例,对比两组患者手术前后的血清MPO水平变化趋势,并采用受试者工作曲线(ROC)分析MPO预测MACE的最佳临界值。结果 :MACE组和非MACE组患者的血Scr、TC、TG、HDL-C、LDL-C、SBP、DBP水平比较差异均无统计学意义;MACE组患者术前、术后30min、术后4h、术后12h、术后24h的外周血MPO水平均显著的高于非MACE组患者;在MPO取值794ng/m L时有最大的诊断指数1.683,此时对应的曲线下面积AUC值为0.841,、灵敏度为86.32%、特异度为81.98%。结论 :AMI患者PCI治疗后并发MACE患者的MPO水平会显著的升高,PCI术后4h的MPO水平预测患者并发MACE具有一定的临床价值。
Objective: To investigate the dynamic changes of myeloperoxidase (MPO) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) and its predictive value in the occurrence of adverse cardiovascular events (MACE). Methods: A total of 127 AMI patients treated with PCI from January 2013 to January 2015 in our hospital were retrospectively analyzed. Forty-three patients with MACE were divided into MACE group and control group according to whether they had adverse cardiovascular events (MACE) Non-MACE group 84 cases, comparing the two groups of patients before and after the operation of serum MPO levels trends, and using the receiver operating curve (ROC) MPO MPE prediction of the optimal critical value. Results: There was no significant difference in the levels of Scr, TC, TG, HDL-C, LDL-C, SBP and DBP between MACE group and non-MACE group before operation, 30min after operation, , The level of MPO in peripheral blood at 12h and 24h after operation was significantly higher than that in non-MACE patients. The maximum diagnostic index was 1.683 when MPO was 794ng / m L, and the corresponding area under the curve AUC was 0.841 The sensitivity was 86.32% and the specificity was 81.98%. Conclusions: The level of MPO in patients with AMI complicated with MACE after AMI is significantly increased. The level of MPO at 4 hours after PCI is associated with the predictive value of MACE in patients with MACE.