降钙素原对急性ST段抬高型心肌梗死急诊PCI术患者不良心血管事件的预测价值

任艳琴; 高胜利; 赵凯华; 郭任维; 马明峰; 郝爱萍; 邢爱华

doi:10.13201/j.issn.1001-1439.2018.04.009

降钙素原对急性ST段抬高型心肌梗死急诊PCI术患者不良心血管事件的预测价值

- 1 山西医科大学附属汾阳医院心内科(山西汾阳, 032200);
- 2 山西医科大学汾阳学院;
- 3 山西医科大学附属汾阳医院放射科
基金项目:
山西省2016重点研发计划攻关项目 (No:201603D321062)

详细信息

通讯作者: 任艳琴,E-mail:ryq.1611@163.com

中图分类号: R541.4

收稿日期: 2018-01-18

Predictive value of procalcitonin for major adverse cardiovascular events in patients with acute ST segment elevation myocardial infarction undergoing emergency PCI

- 1 Department of Cardiology;
- 3 Department of Radiology, Fenyang Hospital of Shanxi Medical University, Fenyang, 032200, China;
- 2 Fenyang College, Shanxi Medical University

More Information

Corresponding author: REN Yanqin, E-mail: ryq.1611@163.com

Received Date: 18 January 2018

摘要

摘要: 目的:了解降钙素原 (PCT) 对急性ST段抬高型心肌梗死 (STEMI) 行急诊经皮冠状动脉 (冠脉) 介入手术 (PCI) 患者的不良心血管事件 (MACE) 的预测价值。方法:选择2016-01-2017-01住院并接受急诊PCI的发病12h内的STEMI患者49例作为STEMI组, 采用Gensini积分法进行冠脉病变程度判定;将同期入院的有非典型胸痛表现且冠脉造影结果正常者47例作为对照组。检测入选患者入院后即刻、24h、1周、1个月时的血清PCT水平, 观察6个月内MACE事件发生情况。结果:与对照组比较, STEMI组PCT在入院24h[(0.023±0.004) ng/ml:(0.231±0.355) ng/ml]和1周时[(0.022±0.004) ng/ml:(0.082±0.070) ng/ml, P＜0.01)]均显著增高 (均P＜0.01)。STEMI组在入院即刻、24h及1周时PCT与冠脉病变程度具有显著相关性 (r值分别为0.497、0.661、0.591, 均P＜0.01)。STEMI组中, 与未发生MACE患者相比, 发生MACE患者PCT水平在入院即刻[(0.042±0.047) ng/ml:(0.263±0.543) ng/ml, P＜0.05]、24h[(0.011±0.097) ng/ml:(0.567±0.556) ng/ml, P＜0.01]及1周时[(0.052±0.025) ng/ml:(0.171±0.088) ng/ml, P＜0.01]均显著升高 (均P＜0.01)。Logistic回归结果表明, PCT为MACE事件的独立预测因子, 其中PCT在入院24h及1周时具有预测作用;入院24h时血清PCT水平ROC曲线下面积为0.931 (P＜0.01), 入院1周时为0.928 (P＜0.01)。结论:行急诊PCI术的STEMI患者PCT在入院24h及1周时明显升高, 与冠脉病变程度呈正相关, 对6个月内的MACE事件具有预测作用。
- 降钙素原 /
- 急性ST段抬高型心肌梗死 /
- 经皮冠状动脉介入手术 /
- 不良心血管事件
Abstract: Objective: To investigate the predictive value of procalcitonin (PCT) for adverse cardiovascular events (MACE) in patients with acute ST segment elevation myocardial infarction (STEMI) undergoing emergency percutaneou coronary intervention (PCI).Method: From January 2016 to January 2017, 49 patients with STEMI who were hospitalized and received emergency PCI within 12 hours were selected as STEMI group, the severity of coronary artery disease was judged by Gensini score.Meanwhile, 47 patients with typical chest pain and normal coronary angiography were enrolled as control group.Levels of serum PCT were detected immediately after admission, 24 hours, 1 week and 1 month, the occurrence of MACE events within 6 months was observed.Result: STEMI group had significantly higher serum PCT level after 24 h [(0.2301±0.004) ng/ml vs (0.231±0.355) ng/ml, P＜0.01] and 1 week [(0.022±0.004) ng/ml vs (0.082±0.070) ng/ml, P＜0.01] as compared with those of control group.There was a significant correlation between the level of PCT and the severity of coronary artery disease at admission, 24 hours and 1 week in STEMI group (r=0.497, 0.661 and 0.591, respectively, P＜0.01).In STEMI group, compared with patients without MACE, PCT levels in patients with MACE significantly increased in immediate [(0.042±0.047) ng/ml vs (0.263±0.543) ng/ml, P＜0.05], 24 h [(0.011±0.097) ng/ml vs (0.567±0.556) ng/ml, P＜0.01] and 1 week [(0.052±0.025) ng/ml vs (0.171±0.088) ng/ml, P＜0.01] .Logistic regression analysis showed that PCT was an independent predictor of MACE events, PCT had a predictive effect at 24 hand 1 week.The area under ROC curve of serum PCT level after 24 hwas 0.931 (P＜0.01), and after 1 week was 0.928 (P＜0.01).Conclusion: The level of serum PCT in patients with STEMI undergoing emergency PCI is significantly increased at 24 hours and 1 week, which is positively correlated with the severity of coronary artery disease, and has a predictive effect on the MACE events within 6 months.
- procalcitonin /
- acute ST segment elevation myocardial infarction /
- percutaneou coronary intervention /
- major adverse cardiovascular events

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