| 苏健楠,赵明,金星,杜永利,李萍.血清视黄醇结合蛋白-4、生长停滞特异性蛋白6水平与急性心肌梗死合并心力衰竭患者预后的关系[J].中国医药导报,2024,21(2):76-80 |
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| 血清视黄醇结合蛋白-4、生长停滞特异性蛋白6水平与急性心肌梗死合并心力衰竭患者预后的关系 |
| Relationship between serum levels of retinol-binding protein-4 and growth-arrest specific protein-6， and prognosis of acute myocardial infarction patients complicated with heart failure |
| 收稿日期：2023-07-04 |
| DOI：10.20047/j.issn1673-7210.2024.02.15 |
| 关键词: 急性心肌梗死 心力衰竭 视黄醇结合蛋白-4 生长停滞特异性蛋白6 预后 |
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| 基金项目:内蒙古自治区自然科学基金项目（2021MS08069） |
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| 摘要:目的 探讨血清视黄醇结合蛋白-4（RBP-4）、生长停滞特异性蛋白6（GAS6）水平与急性心肌梗死（AMI）合并心力衰竭（HF）患者预后的关系。 方法 选取2020年1月至2022年1月内蒙古自治区通辽市医院收治的186例AMI合并HF患者，根据随访1年的预后将其分为预后不良组（61例）和预后良好组（125例）。采用酶联免疫吸附试验检测两组RBP-4、GAS6水平。采用多因素logistic回归模型分析AMI合并HF患者预后不良的影响因素，采用受试者操作特征曲线分析血清RBP-4、GAS6水平对AMI合并HF患者预后不良的预测价值。 结果 预后不良组年龄、急性HF占比、N末端前体B型钠尿肽、RBP-4水平高于预后良好组，左室射血分数、GAS6低于预后良好组，差异有统计学意义（P＜0.05）。多因素分析显示，年龄（OR=1.091，95%CI：1.016～1.173）、急性HF（OR= 2.468，95%CI：1.030～5.913）、N末端前体B型钠尿肽（OR=1.002，95%CI：1.001～1.003）、RBP-4（OR=1.156，95%CI：1.076～1.242）、左室射血分数（OR=0.829，95%CI：0.725～0.948）、GAS6（OR=0.342，95%CI：0.195～0.599）均为AMI合并HF患者预后不良的影响因素（P＜0.05）。受试者操作特征曲线分析显示，血清RBP-4、GAS6水平单独及联合预测AMI合并HF患者预后不良的曲线下面积分别为0.786、0.790、0.895（P＜0.05）。 结论 血清RBP-4水平升高和GAS6水平降低与AMI合并HF患者预后不良有关，二者联合对AMI合并HF患者预后不良具有良好预测价值。 |
| Abstract:Objective To investigate the relationship between serum levels of retinol-binding protein-4 (RBP-4) and growth arrest specific protein 6 (GAS6), and prognosis of patients with acute myocardial infarction (AMI) complicated with heart failure (HF). Methods A total of 186 patients with AMI complicated with HF admitted to Tongliao City Hospital, Inner Mongolia Autonomous Region from January 2020 to January 2022 were selected and divided into poor prognosis group (61 cases) and good prognosis group (125 cases) according to 1-year follow-up. The levels of RBP-4 and GAS6 were detected by enzyme-linked immunosorbent assay. Multivariate logistic regression model was used to analyze the influencing factors of poor prognosis in AMI patients with HF, and the predictive value of serum RBP-4 and GAS6 levels in AMI patients with HF patients was analyzed by receiver operation characteristic curve. Results Age, proportion of patients with acute HF, N-terminal pro B type natriuretic peptide, and RBP-4 levels in the poor prognosis group were higher than those in the good prognosis group, while left ventricular ejection fraction and GAS6 were lower than those in the good prognosis group, the difference were statistically significant (P＜0.05). Multivariate analysis showed that age (OR=1.091, 95%CI: 1.016-1.173), acute HF (OR=2.468, 95%CI: 1.030-5.913), N-terminal pro B type natriuretic peptide (OR=1.002, 95%CI: 1.001-1.003), RBP-4 (OR=1.156, 95%CI: 1.076-1.242), left ventricular ejection fraction (OR=0.829, 95%CI: 0.725-0.948), GAS6 (OR=0.342, 95%CI: 0.195-0.599) were the influential factors of poor prognosis in AMI patients with HF (P＜0.05). The area under the curve of serum RBP-4 and GAS6 alone and in combination predicted poor prognosis in AMI patients with HF were 0.786, 0.790, and 0.895, respectively (P＜0.05). Conclusion The increase of serum RBP-4 level and the decrease of GAS6 level are associated with poor prognosis in patients with AMI combined with HF, and the combination of the two has good predictive value for poor prognosis in patients with AMI combined with HF. |
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