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目的探讨外周血Apelin水平对急性ST段抬高型心肌梗死(ST-elevation myocardial infarction,STEMI)患者病情及预后评估价值。方法 90例STEMI患者,45例直接行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)者为直接PCI组,45例择期接受PCI治疗者为择期PCI组;选择同期45例稳定型心绞痛患者为对照组。检测STEMI患者入院时、PCI术后、出院及随访1a时外周血Apelin水平,并与对照组进行比较;分析Apelin水平与STEMI患者左室射血分数(left ventricular ejection fraction,LVEF)水平和终点事件的关系。结果直接PCI组及择期PCI组患者入院时Apelin水平[(423.6±11.0)、(425.8±10.9)pmol/L)]均低于对照组[(521.5±10.8)pmol/L](P<0.05);术后、出院及随访1a时,直接PCI组Apelin水平[(481.2±10.9)、(480.5±10.5)、(468.9±11.6)pmol/L]较入院时增高(P<0.05),但仍低于对照组(P<0.05);择期PCI组术后、出院时、随访1a时[(431.9±11.2)、(432.5±10.8)、(431.5±11.0)pmol/L]与入院时比较差异无统计学意义(P>0.05);低水平LVEF患者外周血Apelin水平[(400.6±10.1)pmol/L]低于正常水平LVEF患者[(459.8±11.2)pmol/L],差异有统计学意义(P<0.05);随访1a,择期PCI组心血管不良事件发生率(17.8%)高于直接PCI组(13.3%)和对照组(4.4%)(P<0.05)。结论外周血Apelin水平与急性STEMI患者病情及预后有关。
Objective To investigate the clinical value of peripheral blood Apelin levels in patients with acute ST-elevation myocardial infarction (STEMI). Methods Ninety patients with STEMI were enrolled in this study. Forty-five patients undergoing percutaneous coronary intervention (PCI) underwent direct PCI and forty-five patients undergoing elective PCI were enrolled in this study. Forty-five patients with stable angina pectoris group. The levels of Apelin in patients with STEMI admitted to hospital, after PCI, and at the time of discharge and follow-up were detected and compared with that of the control group. The levels of Apelin and left ventricular ejection fraction (LVEF) and end point Relationship. Results The levels of Apelin at admission (423.6 ± 11.0) and (425.8 ± 10.9) pmol / L in PCI group and elective PCI group were significantly lower than those in control group [(521.5 ± 10.8) pmol / L, P < ; The levels of Apelin in the direct PCI group were significantly higher than those on the admission (P <0.05) at the time of discharge, at the time of discharge and at the time of follow-up of 1 year (481.2 ± 10.9), (480.5 ± 10.5) and (468.9 ± 11.6) pmol / (431.9 ± 11.2), (432.5 ± 10.8), (431.5 ± 11.0) pmol / L] at the time of discharge at the time of discharge from the elective PCI group were not significantly different from those of the control group (P <0.05) (P <0.05). The level of Apelin in peripheral blood of patients with low level of LVEF [(400.6 ± 10.1) pmol / L] was lower than that of patients with normal level of LVEF [(459.8 ± 11.2) pmol / L, P <0.05). The incidence of cardiovascular adverse events (17.8%) in the elective PCI group was significantly higher than that of the direct PCI group (13.3%) and the control group (4.4%) at the follow-up of 1 year (P <0.05). Conclusion The level of Apelin in peripheral blood is related to the condition and prognosis of patients with acute STEMI.