發(fā)布時間：2018-05-31 02:02

  本文選題：急性心肌梗死 + 經(jīng)皮冠狀動脈介入治療　； 參考：《中國動脈硬化雜志》2017年06期

【摘要】：目的觀察經(jīng)皮冠狀動脈介入治療術(shù)中出現(xiàn)無復(fù)流現(xiàn)象的急性心肌梗死(AMI)患者生長分化因子15(GDF-15)的表達(dá)水平,探討其對無復(fù)流現(xiàn)象的預(yù)測價值。方法連續(xù)入選南京醫(yī)科大學(xué)附屬常州市第二人民醫(yī)院心血管內(nèi)科住院的急性心肌梗死患者共243例,入院后24 h內(nèi)抽血測定GDF-15濃度,并根據(jù)介入手術(shù)中是否出現(xiàn)無復(fù)流現(xiàn)象分為無復(fù)流組與血流正常組,比較兩組GDF-15表達(dá)水平的差異,評估GDF-15對無復(fù)流現(xiàn)象的預(yù)測價值。結(jié)果無復(fù)流組44例,平均年齡67.00±13.04歲,血流正常組(對照組)199例,平均年齡65.54±12.98歲。無復(fù)流組患者GDF-15濃度高于血流正常組患者(1073.43±364.38 ng/L比714.10±340.98 ng/L,P0.001)。GDF-15預(yù)測無復(fù)流現(xiàn)象的受試者工作特征曲線下面積(AUC)為0.829,95%CI為0.766~0.892。多因素回歸分析提示GDF-15(OR:1.003,95%CI:1.001~1.004,P0.001)和女性(OR:2.996,95%CI:1.358~6.610,P=0.007)是無復(fù)流現(xiàn)象的獨(dú)立危險因素。結(jié)論 GDF-15和女性是急性心肌梗死患者介入治療中無復(fù)流現(xiàn)象的獨(dú)立危險因素。
[Abstract]:Objective to investigate the expression of growth differentiation factor 15 (GDF-15) in patients with acute myocardial infarction (AMI) without reflow during percutaneous coronary intervention (PCI), and to explore the predictive value of GDF-15 in patients with acute myocardial infarction (AMI) without reflow during percutaneous coronary intervention (PCI). Methods A total of 243 consecutive inpatients with acute myocardial infarction were enrolled in the Department of Cardiovascular Medicine of the second people's Hospital of Changzhou affiliated to Nanjing Medical University. The concentration of GDF-15 was measured within 24 hours after admission. According to whether there was no reflow in interventional surgery, the patients were divided into two groups: no reflow group and normal blood flow group. The difference of GDF-15 expression between the two groups was compared, and the predictive value of GDF-15 for no-reflow phenomenon was evaluated. Results 44 cases (mean age 67.00 鹵13.04 years) in non-reflow group and 199 cases (average age 65.54 鹵12.98 years) in control group. The GDF-15 concentration in non-reflow group was higher than that in normal blood flow group (1073.43 鹵364.38 ng/L vs 714.10 鹵340.98 ng 路L ~ (-1) P _ (0.001) P _ (0.001N) 路GDF-15). The area under the operating characteristic curve was 0.829 ~ (95) CI = 0.766 ~ (0.892). Multivariate regression analysis showed that GDF-15 OR: 1.003 and 95% CI: 1.001 + 1.004 (P0.001) and female OR: 2.996 / 95CI: 1.3586.610P0.007) were independent risk factors for no reflow. Conclusion GDF-15 and women are independent risk factors for no reflow in patients with acute myocardial infarction.
【作者單位】： 南京醫(yī)科大學(xué)附屬常州市第二人民醫(yī)院心內(nèi)科;
【分類號】：R542.22

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