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目的 探讨急性心肌梗死患者基质γ-羧基谷氨酸蛋白表达对经皮冠状动脉介入治疗(percutaneous coronary intervention, PCI)术后主要不良心血管事件(major adverse cardiovascular events, MACE)的预测价值。方法 选取2021年11月至2023年9月衡水市人民医院心血管内科住院行PCI术的急性心肌梗死患者157例，根据术后随访12个月MACE发生情况分为MACE组43例和无MACE组114例。采用多因素logistic回归筛选MACE的预测因素并验证其预测价值。结果 MACE组年龄、糖尿病、低密度脂蛋白胆固醇(low density lipoprotein cholesterol, LDL-C)水平明显高于无MACE组，基质γ-羧基谷氨酸蛋白明显低于无MACE组，差异有统计学意义(P<0.05,P<0.01)。多因素logistic回归分析显示，年龄(OR=1.168,95%CI:1.004～1.358,P=0.044)、糖尿病(OR=3.085,95%CI:1.024～9.301,P=0.045)、LDL-C(OR=2.473,95%CI:1.185～5.163,P=0.016)为急性心肌梗死患者PCI术后MACE风险的危险因素，基质γ-羧基谷氨酸蛋白(OR=0.527,95%CI:0.426～0.653,P=0.001)为保护因素。ROC曲线分析显示，基质γ-羧基谷氨酸蛋白对急性心肌梗死患者PCI术后MACE的预测价值最高，曲线下面积为0.838(95%CI:0.770～0.892)。限制性立方样条显示，调整年龄、糖尿病、LDL-C后，基质γ-羧基谷氨酸蛋白与MACE风险呈非线性负相关(χ2=30.260,P<0.05)。结论 基质γ-羧基谷氨酸蛋白可预测急性心肌梗死患者PCI术后MACE发生。
Abstract：Objective To investigate the predictive value of matrix γ-carboxyglutamic acid protein(matrix GLA protein) expression in patients with acute myocardial infarction(AMI) for major adverse cardiovascular events(MACE) after percutaneous coronary intervention(PCI).Methods A total of 157 AMI patients undergoing PCI in our department from November 2021 to September 2023 were recruited, and divided into a MACE group(43 cases) and a non-MACE group(114 cases) based on the occurrence of MACE over a 12-month follow-up period post-surgery.Multivariate logistic regression analysis was used to screen the predictors of MACE and to verify their predictive value.Results The MACE group had significantly older age, larger proportion of diabetes, and higher low-density lipoprotein cholesterol(LDL-C) level, but lower matrix GLA protein level than the non-MACE group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that age(OR=1.168,95%CI:1.004-1.358,P=0.044),diabetes(OR=3.085,95%CI:1.024-9.301,P=0.045) and LDL-C(OR=2.473,95%CI:1.185-5.163,P=0.016) were risk factors, and matrix GLA protein(OR=0.527,95%CI:0.426-0.653,P=0.001) was a protective factor for MACE in AMI patients after PCI.ROC curve analysis indicated that matrix GLA protein had the highest predictive value of MACE in AMI patients after PCI,with an AUC value of 0.838(95%CI:0.770-0.892).After adjusting for age, diabetes, and LDL-C,the restricted cubic spline revealed that matrix GLA protein level was in a nonlinear negative correlation with MACE risk(χ2=30.260,P<0.05).Conclusion Matrix GLA protein can predict the occurrence of MACE in AMI patients after PCI.
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基本信息:
DOI：
中图分类号:R542.22
引用信息:
[1]闫小菊,李萌,刘帅,等.急性心肌梗死患者基质γ-羧基谷氨酸蛋白对经皮冠状动脉介入治疗术后心血管事件的预测[J].中华老年心脑血管病杂志,2025,27(08):986-990.
基金信息:
河北省医学科学研究课题计划项目(20220456); 衡水市科技计划项目(2021014086Z)