补体C1q水平对急性心肌梗死后心衰的预测价值

目的 探讨急性心肌梗死患者血清补体C1q水平与其冠脉狭窄程度及出院后发作心梗后心衰的相关性及其预测价值。方法 选择2020年3月至2021年3月海军军医大学长海医院心内科收治的急性心肌梗死患者162例，测定其发病24 h内的血清补体C1q水平并由高到低排列，按照三分位分组法分为3组，各54例。比较3组间一般基线资料和心功能，随访患者出院后是否发生心衰。采用受试者工作特征曲线（ROC）分析补体C1q水平对患者发生心梗后心衰的预测价值。结果 3组不同C1q水平心梗患者出院后心衰比例差异有统计学意义（P=0.004）。中位随访时间12(11.5,15)个月，随访期共有36例患者发生心梗后心衰。发生心梗后心衰患者的C1q水平低于未发生心梗后心衰的患者[（158.46±33.59）mg/L vs (180.38±34.92)mg/L,t=3.35,P=0.001]。Logistic多因素分析提示，低分位C1q是心梗后心衰的独立危险因素（OR=4.223,95%CI 1.249～14.274,P=0.02）。C1q水平预测心梗后心衰的ROC曲线下面积（AUC）为0.703(95%CI0.627～0...

Effect of complement C1q level in predicting the heart failure following acute myocardial infarction

Objective To explore the correlation of serum complement C1q level and the degree of coronary stenosis and heart failure after myocardial infarction during 1 year after discharge. Methods A total of 162 patients with acute myocardial infarction admitted in Changhai Hospital, Naval Medical University from March 2020 to March 2021 were selected. The plasma complement C1q within 24 h was detected, and patients were divided into three groups according to the level of complement C1q with 54 patients in each group. Baseline data and cardiac function were compared among 3 groups. The follow-up was took to observed whether patients had heart failure within 1 year after discharge. The receiver operating characteristic curve (ROC) was used to analyzed the predictive value of complement C1q to heart failure following acute myocardial infarction. Results There was statistically significant difference in heart failure rate after discharge among the three groups (P=0.004). With a median follow-up time of 12 months, a total of 36 patients developed heart failure after myocardial infarction. C1q level was significantly lower in patients with heart failure 1 year after discharge than in those without heart failure ([158.46±33.59] mg/L vs[180.38±34.92] mg/L, t=3.35, P=0.001). Logistic multivariate analysis suggested that low C1q level was an independent risk factor for heart failure following myocardial infarction (OR=4.223, 95% CI 1.249-14.274, P=0.02).The area under the ROC curve (AUC) of C1q prediting heart failure was 0.703 (95%CI 0.627-0.772). The predicted sensitivity was 41.67% and the specificity was 92.86% with a cut-off value of 138.2 mg/L. Conclusions The lower serum C1q level early after myocardial infarction, the greater the probability of heart failure after discharge.