急性心肌梗死患者血清sLOX-1、ITLN-1水平及与术后无复流现象的相关性分析

目的 探究急性心肌梗死(AMI)患者血清凝集蛋白(Intelectin,ITLN)-1、可溶性凝集素样氧化型低密度脂蛋白受体(sLOX)-1水平及与术后无复流现象的相关性。方法 选取2016年1月～2019年1月我院120例AMI患者作为观察组,另选取120例健康体检者作为对照组。对比两组血清sLOX-1、ITLN-1、肌钙蛋白I(cTnI)、肌红蛋白(Mb)、肌酸激酶同工酶(CK-MB)水平,并分析血清sLOX-1、ITLN-1水平与心肌梗死常用标志物相关性；对比术后无复流、血流正常患者临床指标及血清sLOX-1、ITLN-1水平,分析术后无复流影响因素,并以受试者工作曲线(ROC)评价血清指标对急性心肌梗死患者术后无复流的预测价值。结果 观察组血清sLOX-1、cTnI、Mb、CK-MB水平高于对照组,ITLN-1水平低于对照组(P＜0.05)；AMI患者血清sLOX-1水平与心肌梗死常用标志物cTnI、Mb、CK-MB呈正相关关系(P＜0.05),ITLN-1水平与心肌梗死常用标志物cTnI、Mb、CK-MB呈负相关关系(P＜0.05)；AMI患者中无复流发生率为20%(24/120),年龄、症状至罪犯血管开通时间、TC、BMI、cTnI、Mb、CK-MB、sLOX-1水平均为AMI患者术后无复流独立危险因素,ITLN-1水平为AMI患者术后无复流保护因素(P＜0.05)；ROC曲线显示,血清sLOX-1、ITLN-1联合预测AMI患者术后无复流曲线下面积(AUC)为0.900,明显高于二者单独预测AUC,且敏感度为83.33%,特异度为86.46%。结论 AMI患者血清sLOX-1水平明显升高,ITLN-1水平显著下降,二者均与术后无复流现象有关,且血清sLOX-1、ITLN-1联合预测AMI患者术后无复流价值较高,临床可结合术后无复流发生危险、保护因素,早期预防术后无复流发生。

Correlation analysis of serum sLOX-1 and ITLN-1 levels in patients with acute myocardial infarction and postoperative no-reflow

Objective To investigate the serum Intelectin (ITLN)-1 and solubility Lectin-like oxidized lowdensity lipoprotein receptor (sLOX)-1 levels in patients with acute myocardial infarction (AMI) and their correlation with postoperative no-reflow phenomenon. Methods From January 2016 to January 2019, 120 patients with AMI in our hospital were selected as the observation group, and 120 healthy patients were selected as the control group. Comparing the levels of serum sLOX-1, ITLN-1, troponin I (cTnI), myoglobin (Mb), and creatine kinase isoenzyme (CK-MB) in the two groups, and analyzing the correlation between serum sLOX-1, ITLN-1 levels and commonly used markers of myocardial infarction. Comparing the clinical indexes and serum sLOX-1, ITLN-1 levels of patients without post-reflow and normal blood flow after operation, and analyzing the influencing factors of post-reflow. The receiver operating curve (ROC) was used to evaluate the predictive value of serum indexes for patients with acute myocardial infarction without reflow. Results The levels of serum sLOX-1, cTnI, Mb, CK-MB in the observation group were higher than those in the control group, and the levels of ITLN-1 were lower than those in the control group (P<0.05); the serum sLOX-1 level in AMI patients was positively correlated with the commonly used markers of myocardial infarction cTnI, Mb, CK-MB (P<0.05), ITLN-1 level was negatively correlated with cTnI, Mb, CK-MB, commonly used markers for myocardial infarction (P<0.05); the incidence of no-reflow in AMI patients was 20% (24/120), age, symptoms to the time of criminal vessel opening, TC, BMI, cTnI, Mb, CK-MB, sLOX-1 levels were all independent risk factors for post-reflow in patients with AMI, ITLN-1 level was the protective factor of AMI patients without reflow after operation (P<0.05); the ROC curve shows that the combined area under the curve (AUC) of serum sLOX-1 and ITLN-1 for predicting post-reflow in AMI patients was 0.900, which was significantly higher than the two predicting AUC alone, and the sensitivity was 83.33% and the specificity was 86.46%. Conclusion The serum sLOX-1 level in patients with AMI is significantly increased, and the ITLN-1 level is significantly decreased. Both of them are related to the absence of reflow after operation, and the combined value of serum sLOX-1 and ITLN-1 in predicting post-reflow without AMI is higher. Clinically, combined with the risk and protective factors of no postoperative reflow, it is possible to prevent early postoperative reflow.