血浆sST2、cTnI、hs-CRP、NT-proBNP水平对急性心肌梗死患者不良心血管事件的评估价值-东南大学学报医学版

血浆sST2、cTnI、hs-CRP、NT-proBNP水平对急性心肌梗死患者不良心血管事件的评估价值

单位：1. 文昌市人民医院心血管内科, 海南文昌 571300;
2. 海南省人民医院心血管内科, 海南海口 570311

关键词：急性心肌梗死可溶性致癌抑制因子2 心肌肌钙蛋白I 高敏-C反应蛋白 N端脑钠肽前体

分类号：R542.22

出版年·卷·期（页码）：2019·38·第五期（843-847）

摘要：

目的：初步研究血浆可溶性致癌抑制因子2（sST2）、心肌肌钙蛋白I（cTnI）、高敏-C反应蛋白（hs-CRP）和N端脑钠肽前体（NT-proBNP）在急性心肌梗死（AMI）患者主要不良心血管事件（MACE）中的评估价值。方法：前瞻性纳入我院2016年3月至2017年4月收治的128例首次发病的AMI患者为试验组，同时选择128例同期健康体检者作为对照组。采用ELISA法检测血浆中sST2、cTnI、hs-CRP、NT-proBNP水平，比较两组间的差异，并随访AMI患者出院后6个月内MACE的发生率，采用受试者工作特征曲线（ROC）计算血浆sST2、cTnI、hs-CRP、NT-proBNP水平预测患者MACE发生的曲线下面积（AUC）。结果：试验组患者血浆sST2、cTnI、hs-CRP、NT-proBNP水平显著高于对照组，差异具有统计学意义（P<0.05）。AMI患者出院后6个月内发生MACE者血浆sST2、cTnI、hs-CRP、NT-proBNP水平明显高于未发生MACE者（P<0.05）。ROC显示，血浆sST2、cTnI、hs-CRP、NT-proBNP水平均能预测患者MACE的发生，AUC分别为0.8732、0.691 6、0.817 4、0.742 5；sST2的AUC明显高于其他指标（均P<0.05），表明sST2的预测价值最高。结论：血浆sST2、cTnI、hs-CRP、NT-proBNP水平对评估AMI患者MACE的发生具有一定的临床价值，其中sST2对患者6个月MACE的发生预测价值最高。

Objective: To investigate the value of soluble carcinogenic inhibitor 2 (sST2), cardiac troponin I (cTnI), high-sensitivity C-reactive protein (hs-CRP) and N-terminal brain natriuretic peptide precursor (NT-proBNP) in evaluating major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI). Methods: 128 cases of first onset AMI patients treated in our hospital from March 2016 to April 2017 were prospectively enrolled as the experimental group. At the same time, 128 cases of healthy persons were selected as the control group. After admission, the levels of sST2, cTnI, hs-CRP and NT-proBNP in plasma were detected by ELISA method, and the difference between the two groups was compared. The incidence of MACE in patients with AMI during 6 months was followed up. The relationship between the above indexes and the prognosis of patients with AMI were analyzed. The area under curve (AUC) of the level of sST2, cTnI, hs-CRP and NT-proBNP in plasma in predicting the incidence of MACE was calculated. Results: The concentrations of sST2, cTnI, hs-CRP and NT-proBNP in the experimental group were significantly higher than those in the control group (P<0.05). In addition, the levels of sST2, cTnI, hs-CRP and NT-proBNP in acute myocardial infarction patients with MACE within 6 months were significantly higher than those without MACE. ROC results showed that sST2, cTnI, hs-CRP and NT-proBNP levels in plasma could predict the incidence of MACE in patients, AUC was 0.8732, 0.691 6, 0.817 4 and 0.742 5, respectively. The AUC of sST2 was significantly higher than that of other indicators (all P<0.05), indicating that the prediction value of sST2 was the highest. Conclusion: The levels of ST2, cTnI, hs-CRP and NT-proBNP in plasma are of certain clinical value for the prognosis of AMI. The predictive value of sST2 on the incidence of MACE at 6 months is the highest.

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