| 刘红菊,禹海文.血浆 Apelin-12水平对急性心肌梗死后心力衰竭发生的预测价值[J].安徽医药,2021,25(4):797-800. |
| 血浆 Apelin-12水平对急性心肌梗死后心力衰竭发生的预测价值 |
| Predictive value of plasma Apelin-12 level in the occurrence of heart failure after acute myocardial infarction |
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| DOI：10.3969/j.issn.1009-6469.2021.04.040 |
| 中文关键词: 心肌梗死 心力衰竭 Apelin 肌钙蛋白 I 肌酸激酶 预测 |
| 英文关键词: Myocardial infarction Heart failure Apelin Troponin I Creatine kinase Prediction |
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| 中文摘要: |
| 目的探讨血浆 Apelin-12水平对急性心肌梗死(AMI)后心力衰竭(HF)发生的预测价值。方法选取 2018年 6月至 2019年 6月郑州煤炭工业(集团)有限责任公司总医院心血管内科收治的 AMI病人 210例作为研究对象，根据 AMI治疗 1周后是否发生 HF将其分为非 HF组(n=131)和 HF组(n=79)。收集两组病人临床资料，使用酶联免疫吸附法(ELISA)测定血浆 Apelin-12水平。采用多变量 logistic回归分析影响 AMI后 HF发生的危险因素；并绘制受试者工作特征曲线(ROC)，分析肾小球滤过率估算值(eGFR)左室射血分数(LVEF)及血浆 Apelin-12水平对 AMI后 HF发生的预测价值。结果 HF组血清心肌肌钙蛋白 I(cTnI)(4.09±1.06)、μg/L、肌酸激酶同工酶(CK-MB)(119.24±32.45)U/L水平明显高于非 HF组(3.77±0.96)μg/L、(95.60±24.81)U/L(P<0.05)，eGFR(86.29±23.10)mL·min-1·(1.73 m2)-1、LVEF(43.87±11.62)%及血浆 Apelin-12水平(0.51±0.14)μg/L均明显低于非 HF组(103.55±26.76)mL·min-1·(1.73 m2)-1、(56.94±15.03)%、(0.63±0.18)μg/L(P<0.05)。 HF病人不同 Killip分级间血浆 Apelin-12水平及 LVEF高低依次为 Killip Ⅱ级、 Killip Ⅲ级、 Killip Ⅳ级，组间两两比较均差异有统计学意义(P<0.05)。 Pearson检验分析显示， HF病人血浆 Apelin-12水平与 LVEF呈正相关(P<0.05)。多变量 logistic回归分析显示， eGFR、LVEF及血浆 Apelin-12水平均是影响 AMI后 HF发生的独立危险因素(P<0.05)。 ROC曲线分析显示，血浆 Apelin-12水平预测 AMI后 HF发生的曲线下面积(AUC)高于 eGFR和 LVEF，最佳截断值为 0.57 μg/L时预测灵敏度为 87.10%，特异度高达 91.40%。结论 AMI后发生 HF病人血浆 Apelin-12水平明显降低，可作为评估 AMI后 HF发生的潜在标记物。 |
| 英文摘要: |
| Objective To investigate the predictive value of plasma Apelin-12 level in the occurrence of heart failure (HF) after acute myocardial infarction (AMI).Methods Two hundred and ten patients with AMI admitted to the Department of Cardiology, General Hospital of Zhengzhou Coal Industry (Group) Co., Ltd. from June 2018 to June 2019 were selected as the study subjects. They wereassigned into non-HF group (n=131) and HF group (n=79) according to the occurrence of HF one week after the treatment of AMI. Clinical data of the two groups were collected and plasma Apelin-12 level was measured by ELISA. Multivariate logistic regression analysiswas used to analyze the risk factors of HF after AMI, and subject operating characteristic curve (ROC) was drawn to analyze the predictive values of glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF) and plasma Apelin-12 level for HF after AMI. Results The levels of serum cardiac troponin I (cTnI) (4.09±1.06) μg/L and creatine kinase isoenzyme (CK-MB) (119.24±32.45) U/L in HF group were significantly higher than those in non-HF group (3.77±0.96) μg/L, (95.60±24.81) U/L (P<0.05), and the levels of eG‐FR (86.29±23.10) mL·min-1·(1.73 m2)-1, LVEF (43.87±11.62)% and plasma Apelin-12 (0.51±0.14) μg/L were significantly lower than those in non-HF group (103.55±26.76) mL·min-1·(1.73 m2)-1, (56.94±15.03) %, (0.63±0.18) μg/L (P<0.05). The levels of Apelin-12 and LVEF in HF patients with different Killip grades were Killip Ⅱ, Killip Ⅲ and Killip Ⅳ in turn, and there were significant differencesbetween the two groups (P<0.05). Pearson test showed that plasma Apelin-12 level was positively correlated with LVEF in HF patients (P<0.05). Multivariate logistic regression analysis showed that eGFR, LVEF and plasma Apelin-12 levels were independent risk factors for HF after AMI (P<0.05). ROC curve analysis showed that the area under curve (AUC) of plasma Apelin-12 level in predicting HF after AMI was higher than that of eGFR and LVEF. The sensitivity and specificity of prediction were 87.10% and 91.40% when the optimal truncation value was 0.57 μg/L.Conclusion The plasma Apelin-12 level in patients with HF after AMI is significantly decreased,which can be used as a potential marker for evaluating the occurrence of HF after AMI. |
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