摘要
目的探讨急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)术前、后外周血平均血小板体积(MPV)、血清血管内皮生长因子(VEGF)、基质金属蛋白酶9(MMP-9)变化及其与预后的关联性。方法选取海南省老年病医院ACS患者96例的资料进行回顾性分析。PCI术后6月发生主要不良心血管事件(MACE)15例纳入MACE组,未出现MACE的81例纳入无MACE组。比较两组PCI术前、后外周血MPV及血清VEGF、MMP-9水平,以受试者工作特征曲线(ROC)分析外周血MPV及血清VEGF、MMP-9对ACS患者PCI术后MACE的预测价值,探讨ACS患者预后影响因素。结果ACS患者PCI术后3天、术后7天外周血MPV及血清VEGF、MMP-9水平低于术前(P<0.05)。MACE组PCI术前、术后3天、术后7天上述各指标高于无MACE组(P<0.05)。ROC分析显示,PCI术后7天MPV的曲线下面积(AUC)为0.987,大于术前、术后3天,当截断值>11.27 fL时,其预测ACS行PCI术患者出现MACE的灵敏度为96.67%,特异度为96.20%。PCI术后7天VEGF的AUC为0.906,当截断值>173.80 ng/L时,其预测MACE的灵敏度为83.33%,特异度为88.61%。PCI术后7天MMP-9的AUC为0.843,当截断值>334.74μg/L时,其预测MACE的灵敏度为73.33%,特异度为87.34%。结论ACS患者PCI术后外周血MPV及血清VEGF、MMP-9水平显著降低。外周血MPV及血清VEGF、MMP-9均为ACS患者PCI术后出现MACE的重要危险因素,对预测MACE具有较高的临床价值。
Aim To investigate the changes of peripheral blood mean platelet volume(MPV),serum vascular endothelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9)in patients with acute coronary syndrome(ACS)before and after percutaneous coronary intervention(PCI)and their correlation with prognosis.Methods The data of 96 patients with ACS in Geriatrics Hospital of Hainan were retrospectively analyzed.15 patients with major adverse cardiovascular events(MACE)6 months after PCI were included in the MACE group,and 81 patients without MACE were included in the non-MACE group.The levels of MPV of peripheral blood,serum VEGF and MMP-9 were compared between the two groups before and after PCI.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of MPV of peripheral blood,serum VEGF and MMP-9 for MACE after PCI in ACS patients.The factors influencing prognosis of ACS patients were discussed.Results The levels of MPV of peripheral blood,serum VEGF and MMP-9 in ACS patients at 3 days and 7 days after PCI were lower than those before PCI(P<0.05).The above indexes of MACE group before PCI,3 days and 7 days after PCI were higher than those in non-MACE group(P<0.05).ROC analysis showed that the area under curve(AUC)of MPV at 7 days after PCI was 0.987,which was larger than those before PCI and 3 days after PCI;When the cut-off value was greater than 11.27 fL,the sensitivity and specificity of MPV in predicting MACE in ACS patients undergoing PCI were 96.67%and 96.20%respectively.The AUC of VEGF was 0.906 at 7 days after PCI;When the cut-off value was greater than 173.80 ng/L,the sensitivity and specificity of VEGF in predicting MACE were 83.33%and 88.61%respectively.The AUC of MMP-9 was 0.843 at 7 days after PCI;When the cut-off value was greater than 334.74μg/L,the sensitivity and specificity of MMP-9 in predicting MACE were 73.33%and 87.34%respectively.Conclusions The levels of MPV of peripheral blood,serum VEGF and MMP-9 are significantly decreased in ACS patients after PCI.MPV,VEGF and MMP-9 are important risk factors of MACE in ACS patients undergoing PCI,which have high clinical value in predicting MACE.
作者
陈建军
刘扬河
曾校
谭业农
CHEN Jianjun;LIU Yanghe;ZENG Xiao;TAN Yenong(Department of Geriatrics,Cadre Sanatorium of Hainan&Geriatrics Hospital of Hainan,Haikou,Hainan 571100,China;Department of Rehabilitation,Cadre Sanatorium of Hainan&Geriatrics Hospital of Hainan,Haikou,Hainan 571100,China;Department of Otolaryngology,Hainan Provincial Hospital of Traditional Chinese Medicine,Haikou,Hainan 570203,China)
出处
《中国动脉硬化杂志》
CAS
2020年第11期986-990,1008,共6页
Chinese Journal of Arteriosclerosis
基金
海南省医药卫生科研项目(1326360·10A2010)。
