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目的:探讨血浆成纤维细胞生长因子23(FGF-23)对急性心肌梗死合并心源性休克患者预后的预测价值。方法:选择2014-01-2015-06收入我院重症医学科的52例急性心肌梗死合并心源性休克的患者。收集患者入院时年龄、性别、BMI、心率等一般资料,记录患者入院时和治疗2d后的血浆FGF-23水平、肌酐、乳酸、肌钙蛋白T水平。根据患者入院28d的患者存活情况,分为存活组(n=28)和死亡组(n=24)。分析各参数并评估其对短期预后的预测价值。结果:2组患者在性别、年龄、BMI、心率等方面差异无统计学意义。对比入院时和住院2d后患者的血浆FGF-23水平、肌酐、乳酸、肌钙蛋白T、血磷水平,死亡组均显著性升高(P<0.001)。对比2组患者入院时和治疗2天后血钙水平,其中入院时2组患者的血钙水平差异无统计学意义;治疗2d后2组患者的血钙水平显著性升高(P<0.001)。经Pearson相关性分析发现,血FGF-23水平和患者的病死率呈正相关。结论:在急性心肌梗死合并心源性休克的患者中,FGF-23是一个预后危险预测价值,血浆FGF-23水平高的患者存在更高的短期死亡风险。
Objective: To investigate the predictive value of FGF-23 in patients with acute myocardial infarction complicated with cardiogenic shock. Methods: Forty-two patients with acute myocardial infarction complicated with cardiogenic shock who were admitted to our hospital from January 2014 to January 2015 were enrolled in this study. Collect general information such as age, sex, BMI and heart rate on admission, record the level of plasma FGF-23, creatinine, lactate and troponin T at admission and 2 days after treatment. Patients were divided into survival group (n = 28) and death group (n = 24) according to their survival on the 28th day. Analyze the parameters and assess their predictive value for short-term prognosis. Results: There was no significant difference in gender, age, BMI, heart rate among the two groups. The levels of creatinine, lactate, troponin T, serum phosphorus level and death group were significantly higher (P <0.001) compared with those on admission and 2 days after hospitalization. The level of serum calcium was compared between two groups after admission and two days after treatment. There was no significant difference in serum calcium levels between the two groups on admission. Serum calcium levels were significantly increased in both groups after 2 days of treatment (P <0.001). Pearson correlation analysis found that serum FGF-23 levels and the patient’s mortality was positively correlated. CONCLUSIONS: FGF-23 is a predictor of prognostic risk in patients with acute myocardial infarction complicated with cardiogenic shock, with a higher risk of short-term mortality in patients with high plasma FGF-23 levels.