摘要
目的探讨ST段抬高型心肌梗死(STEMI)患者血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)与经皮冠状动脉介入(PCI)术后并发症交互作用对预后不良的影响。方法选取2017年1月至2020年1月该院收治的400例STEMI患者作为研究对象,根据患者2年预后情况分为预后良好组(n=378)与预后不良组(n=22)。采用Logistic回归方程分析STEMI患者预后影响因素,建立相乘和相加效应分析血清NGAL与PCI术后并发症交互作用对预后不良的影响。结果性别、年龄、心率、冠脉狭窄程度积分(Gensini积分)、病变支数≥2支、Killip分级、PCI术后并发症及PCI术后NGAL水平均与STEMI患者预后不良有关(P<0.05);性别(女)、年龄、心率、Gensini积分、病变支数≥2支、Killip分级、PCI术后并发症及PCI术后NGAL水平均与STEMI患者预后不良独立影响因素(P<0.05);PCI术后血清NGAL与PCI术后并发症存在交互作用,均对STEMI患者预后不良有影响(P<0.05);PCI术后血清NGAL、PCI术后并发症之间并无相乘交互作用(P>0.05);PCI术后血清NGAL、PCI术后并发症同时暴露时,STEMI患者预后不良风险高于二者单独暴露风险之和,交互作用为二者单独暴露产生作用之和的2.611倍。结论血清NGAL与PCI术后并发症是STEMI患者预后不良的独立影响因素,二者存在相加交互作用,同时暴露可增加预后不良的危险性。
Objective To investigate the effect of interaction between serum neutrophil gelatinase-associated lipid carrier protein(NGAL)and complications after percutaneous coronary intervention(PCI)on poor prognosis in patients with ST-segment elevation myocardial infarction(STEMI),and to provide reference for improving prognosis.Methods From January 2017 to January 2020,a total of 400 STEMI patients admitted to this hospital were selected and divided into good prognosis group(n=378)and poor prognosis group(n=22)according to their 2-year prognosis.Logistic regression equations were used to analyze the prognostic factors of STEMI patients,and multiplicative and additive effects were established to analyze the effect of the interaction between serum NGAL and post-PCI complications on poor prognosis.Results Gender,age,heart rate,Gensini score,number of lesions≥2,Killip grade,complications after PCI and NGAL level after PCI were associated with poor prognosis in STEMI patients(P<0.05).Gender(female),age,heart rate,Gensini score,number of lesions≥2,Killip grade,complications after PCI and NGAL level after PCI were all independent influencing factors of poor prognosis in STEMI patients(P<0.05).There was interaction between serum NGAL after PCI and complications after PCI,both of which had an adverse effect on the prognosis of STEMI patients(P<0.05).There was no multiplicative interaction between serum NGAL and complications after PCI(P>0.05).When serum NGAL and complications after PCI were exposed at the same time,the risk of poor prognosis in STEMI patients was higher than the sum of the two exposures alone,and the interaction was 2.611 times the sum of the effects of the two exposures alone.Conclusion Serum NGAL and postoperative complications after PCI are independent factors influencing poor prognosis in STEMI patients.There is a additive interaction between the two factors,and exposure can increase the risk of poor prognosis.
作者
赵晓东
舒建宇
赵荣荣
毛建云
刘斌
ZHAO Xiaodong;SHU Jianyu;ZHAO Rongrong;MAO Jianyun;LIU Bin(Department of Cardiovascular,Zhangjiakou First Hospital,Zhangjiakou,Hebei 075000,China;Catheter Room,Zhangjiakou First Hospital,Zhangjiakou,Hebei 075000,China;Department of Nephrology,Zhangjiakou First Hospital,Zhangjiakou,Hebei 075000,China;Department of Hematology,Zhangjiakou First Hospital,Zhangjiakou,Hebei 075000,China)
出处
《国际检验医学杂志》
CAS
2024年第18期2234-2239,共6页
International Journal of Laboratory Medicine
基金
河北省卫生健康委医学科学研究课题计划(20210315)。
关键词
ST段抬高型心肌梗死
中性粒细胞明胶酶相关脂质运载蛋白
经皮冠状动脉介入
交互作用
预后
ST-segment elevation myocardial infarction
neutrophil gelatinase-associated lipid carrier protein
percutaneous coronary intervention
interaction
prognosis
