| 李小琴,石小燕,李芳,等.血清中巨噬细胞移动抑制因子水平对急性 ST段抬高心肌梗死的预后价值[J].安徽医药,2021,25(12):2420-2424. |
| 血清中巨噬细胞移动抑制因子水平对急性 ST段抬高心肌梗死的预后价值 |
| Prognostic value of serum macrophage migration inhibitory factor in patients with acute ST-segment elevation myocardial infarction |
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| DOI：10.3969/j.issn.1009-6469.2021.12.021 |
| 中文关键词: ST段抬高心肌梗死 标志物 巨噬细胞移动抑制因子 心脏高敏感性肌钙蛋白 T 预后 |
| 英文关键词: ST elevation myocardial infarction Marker Macrophage migration inhibitory factor Cardiac hypersensitive tropo. nin T Prognosis |
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| 中文摘要: |
| 目的评估血清中巨噬细胞移动抑制因子( migration inhibitory factor，MIF)水平对急性 ST段抬高心肌梗死( STEMI)病人预后的价值。方法收集 2014年 1月至 2016年 1月到济源市第二人民医院接受治疗的急性 STEMI病人 273例临床资料及常规检测指标的结果，随访 36个月，根据随访结束时病人的生存状态将其分为死亡组和未死亡组；酶联免疫吸附测定检测急性 STEMI病人外周血中 MIF水平；自动生化分析仪检测肌酸激酶同工酶(CK-MB)和心脏高敏感性肌钙蛋白 T(hs-TnT)；受试者工作特征曲线检测 MIF、hs-TnT和 CK-MB判断急性 STEMI病人预后的灵敏度和特异度，并根据 MIF的截断值，将病人分为 MIF高表达组和低表达组；检测 MIF高表达组与 MIF低表达组病人入院后 hs-TnT和 CK-MB水平的变化；分析 MIF、hs-TnT和 CK-MB不同表达水平对急性 STEMI病人预后的影响。 logistic多因素回归分析影响急性 STEMI不良预后的独立危险因素。结果死亡组病人的肌酐［( 9 405±2 086)μmol/L］、 Gensini评分［( 92.0±23.0)分］，外周血中 MIF［( 234.5±32.5)μg/L］、 hs-TnT［( 6.3(0.2，12.3)mg/L］和 CK-MB［253(95，318)U/L］水平均显著高于未死亡组肌酐［(7 231±1 352)μmol/L］、 Gensini评分［(67.0±18.0)分］，外周血中 MIF［( 156.2±19.7)μg/L］、 hs-TnT［1.5(0.1，2.3)mg/L］和 CK-MB［124(72，237)U/L］水平( P<0.001)； MIF判断急性 STE. MI病人预后的灵敏度和特异度均高于 CK-MB，略低于 hs-TnT；MIF高表达组 hs-TnT水平在入院 12 h时达高峰，且高于 MIF低表达组。 MIF高表达组 CK-MB水平入院 8h时达高峰，且高于 MIF低表达组； MIF、hs-TnT和 CK-MB高表达组病人的存活率分别为 80.5%、77.3%和 79.8%，均低于 MIF、hs-TnT和 CK-MB低表达组 81.4%、97.3%和 95.2%(均 P<0.05)； MIF≥123.4 μg/L、hs-TnT≥0.92 mg/L和 CK-MB≥108 U/L为急性 STEMI病人预后不良的独立危险因素。结论 MIF评估急性 STEMI病人预后的灵敏度略低于 hs-TnT，其是否有望成为评估急性 STEMI病人预后的有效指标，还需扩大样本量做进一步研究。 |
| 英文摘要: |
| Objective To evaluate the value of serum macrophage migration inhibitory factor (MIF) levels in the prognosis of pa. tients with acute ST-segment elevation myocardial infarction (STEMI).Methods A total of 273 patients with acute STEMI who weretreated in Second People′s Hospital of Jiyuan City from January 2014 to January 2016 were collected. The clinical data and routine testresults were collected. Followed up for 36 months, according to the survival status of patients at the end of follow-up, they were assigned into dead group and undead group. Enzyme-linked immunosorbent assay (ELISA) was used to detect MIF levels in peripheral blood ofpatients with acute STEMI. Automated biochemical analyzer was used to detect creatine kinase isoenzyme (CK-MB) and cardiac hyper. sensitive troponin T (hs-TnT). The receiver operating curve was used to detect the sensitivity and specificity of MIF, hs-TnT and CK-MB in predicting the prognosis of patients with acute ST-segment elevation myocardial infarction. According to the cutoff value of MIF,patients were assigned into MIF high expression group and low expression group. The changes of hs-TnT and CK-MB levels in patientswith MIF high expression group and MIF low expression group after admission were detected. The effects of different expression levelsof MIF, hs-TnT and CK-MB on the prognosis of patients with ST-segment elevation myocardial infarction were analyzed; logistic multi.variate regression analysis was an independent risk factor affecting the poor prognosis of ST segment elevation myocardial infarction.Re. sults The creatinine [(9 405±2 086) μmol/L vs. (7 231±1 352) μmol/L], Gensini score [(92.0±23.0) points vs. (67.0±18.0) points] and peripheral blood MIF [(234.5±32.5) μg/L vs. (156.2±19.7) μg/L], hs-TnT [6.3 (0.2,12.3) mg/L vs. 1.5 (0.1,2.3) mg/L] and CK-MB [253 (95,318) U/L vs. 124(72,237) U/L] in the dead group were significantly higher than those in the non-dead group (P<0.001). The sensitiv. ity and specificity of MIF in predicting the prognosis of patients with acute STEMI were higher than CK-MB and slightly lower than hs-TnT. The hs-TnT level in the MIF high expression group peaked at 12 h after admission and was higher than the MIF low expressiongroup. The level of CK-MB in the MIF high expression group reached a peak at 8 h, and was higher than the MIF low expression group.The survival rates of patients in the MIF, hs-TnT, and CK-MB high expression groups were 80.5%, 77.3%, and 79.8%, respectively,which were lower than 81.4%, 97.3%, and 95.2% of the MIF, hs-TnT, and CK-MB low expression groups (all P<0.05). MIF≥123.4 μg/ L, hs-TnT≥0.92 mg/L and CK-MB≥108 U/L were independent risk factors for poor prognosis in patients with acute STEMI.Conclu. sions The sensitivity of MIF to assess the prognosis of patients with acute STEMI is slightly lower than hs-TnT. Whether it is expected to be an effective indicator for evaluating the prognosis of patients with ST-elevation myocardial infarction, the sample size needs to be expanded for further research. |
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