可溶性ST2对急性ST段抬高型心肌梗死患者临床预后的预测价值

目的探讨可溶性ST2(sST2)水平对急性ST段抬高型心肌梗死(STEMI)患者6个月内发生心力衰竭或心源性死亡的预测价值。方法选择就诊于我院心内科并确诊为STEMI患者117例,入院时采用酶联免疫吸附法测定患者血浆sST2水平,随访并记录6个月内MACE(定义为新发心力衰竭或心源性死亡)发生情况。依据是否发生MACE分为MACE事件组与非MACE事件组,分析两组一般资料,并行COX多因素回归分析STEMI患者发生MACE的独立危险因素。结果117例STEMI患者随访6个月内,发生心力衰竭20例,心源性死亡2例。Spearman相关分析结果显示,基线sST2与基础心率、cTnT峰值、Killip分级、NT-proBNP呈正相关(r=0.253、0.335、0.401、0.467,P<0.05),与LVEF呈负相关(r=-0.201,P<0.05)。多因素COX回归分析提示基线sST2值是STEMI患者发生MACE事件的独立危险因素(HR=1.817,P=0.001);而LVEF、cTnT峰值也可独立预测患者MACE事件的发生(HR=0.818、1.328,P=0.003、0.001)。结论基线sST2水平与STEMI患者的临床预后有关,可独立预测患者6个月内MACE的发生风险。

Predictive value of soluble ST2 in clinical prognosis of patients with acute ST-segment elevation myocardial infarction

Objective To investigate the predictive value of serum soluble ST2(sST2)level on heart failure or cardiac death in patients with acute ST-segment elevation myocardial infarction(STEMI)within 6 months.Methods A total of117 patients with STEMI were confirmed in the cardiology department of our hospital.The plasma ST2 level was measured by enzyme-linked immunosorbent assay(ELISA)at admission.The occurrence of MACE(defined as new heart failure or cardiac death)was followed up and recorded within 6 months.According to the occurrence of MACE,the patients were divided into MACE event group and non-MACE event group.The general data of the two groups were analyzed,and the independent risk factors of MACE in STEMI patients were analyzed by COX multiple factor regression.Results During the follow-up of 117 patients with STEMI for 6 months,20 cases developed heart failure and2 cases cardiac died.The Spearman correlation analysis showed that baseline sST2 were positively correlated with basal heart rate,cTnT peak value,Killip grade,NT-proBNP(r=0.253,0.335,0.401,0.467,P<0.05),and negatively correlated with LVEF(r=-0.201,P<0.05).The multivariate COX regression analysis showed that the baseline sST2 was an independent risk factor for MACE in STEMI patients(HR=1.817,P=0.001),while LVEF and cTnT peak value can also independently predict the occurrence of MACE events(HR=0.818,1.328;P=0.003,0.001).Conclusion Baseline s ST2 level is associated with clinical prognosis in STEMI patients and can independently predict the risk of MACE in patients within 6 months.