| 李波,呼子珍.血清H-FABP水平与急性心肌梗死患者疾病转归的关联性及其联合TEG相关参数的预测效能[J].济宁医学院学报,2025,48(5):385-389 |
| 血清H-FABP水平与急性心肌梗死患者疾病转归的关联性及其联合TEG相关参数的预测效能 |
| Association between serum H-FABP level and disease outcomes of patientswith acute myocardial infarction and its predictive efficacy combined with TEG-related parameters |
| 投稿时间：2025-05-30 |
| DOI：10.3969/j.issn.1000-9760.2025.05.001 |
| 中文关键词: 急性心肌梗死;疾病转归;心型脂肪酸结合蛋白;血栓弹力图 |
| 英文关键词: Acute myocardial infarction;Disease outcome;H-FABP;TEG |
| 基金项目:延安市科技计划项目(2024-SFG G-201) |
| 作者 | 单位 | | 李波 | 延安大学医学院, 延安 716000 | | 呼子珍 | 延安市中医医院全科医学科, 延安 716000 |
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| 中文摘要: |
| 目的 探讨血清心型脂肪酸结合蛋白(H-FABP)水平与急性心肌梗死(AMI)患者疾病转归的相关性及其联合血栓弹力图(TEG)相关参数的预测效能。方法 选取我院2022年8月至2024年9月收治的137例AMI患者为研究对象，所有患者均接受经皮冠状动脉介入(PCI)治疗，根据PCI术后6个月是否发生主要不良心血管事件将患者分为预后良好组(102例)和预后不良组(35例)。比较两组PCI术后3 d血清H-FABP水平及TEG相关参数[凝血反应时间(R)、血凝块形成时间(K)、血凝块形成速率(α角)、血凝块形成后最大振幅(MA)]，分析两者间的相关性、影响AMI患者预后的危险因素，以及血清H-FABP水平联合TEG参数对AMI患者预后的预测价值。结果 与预后良好组相比，预后不良组PCI术后3 d血清H-FABP水平、α角、MA值较高(t=12.949、5.963、14.284，P＜0.05)，R值、K值较低(t=8.255、8.749，P＜0.05)；PCI术后3 d，血清H-FABP水平、α角、MA值、R值、K值与预后相关(r=0.635、0.624、0.503、-0.578、-0.611，P＜0.05)；Logistic回归分析显示，校正发病至PCI时间、PCI术后3 d血清CK、CK-MB、cTnI、BNP水平因素后，H-FABP水平、R值、K值、α角、MA值是影响AMI患者预后的重要因素(B=0.147、-0.060、-0.068、0.178、0.166，P＜0.05)；ROC曲线结果显示，PCI术后3 d血清H-FABP水平联合R值、K值、α角、MA值预测AMI患者预后的AUC优于单一诊断。结论 血清H-FABP水平与AMI患者PCI术后预后有关，联合TEG相关参数预测，能提高临床对预后的预测价值。 |
| 英文摘要: |
| Objective To investigate the correlation between serum heart-type fatty acid binding protein (H-FABP) level and disease outcomes in patients with acute myocardial infarction (AMI) and its predictive efficacy combined with thrombelastogram (TEG) related parameters. Methods A total of 137 AMI patients admitted to our hospital from August 2022 to September 2024 were selected as the research subjects. All patients received percutaneous coronary intervention (PCI) treatment. The patients were divided into the good prognosis group (102 cases) and the poor prognosis group (35 cases) based on whether major adverse cardiovascular events occurred within 6 months after PCI. The serum H-FABP levels and TEG-related parameters [coagulation reaction time (R), blood clot formation time (K), blood clot formation rate (α Angle), maximum amplitude after blood clot formation (MA)] at 3 days after PCI in the two groups were compared, and the correlation between the two and the risk factors affecting the prognosis of AMI patients were analyzed. And the predictive value of serum H-FABP level combined with TEG parameters for prognosis in AMI patients were also analyzed. Results Compared with the good prognosis group, the serum H-FABP level, α Angle and MA value were higher in the poor prognosis group at 3 days after PCI (t=12.949, 5.963, 14.284, P < 0.05), while the R value and K value were lower (t=8.255、8.749, P < 0.05);the serum H-FABP level, α Angle and MA value at 3 days after PCI were correlated with prognosis (r=0.635、0.624、0.503、-0.578、-0.611, P < 0.05). Logistic regression analysis showed that after adjusting for the time from onset to PCI, and the levels of serum CK, CK-MB, cTnI, and BNP at 3 days after PCI, the level of H-FABP, R value, K value, α Angle, and MA value remained the influencing factors for prognosis in AMI patients (B=0.147、-0.060、-0.068、0.178、0.166, P < 0.05);the results of the ROC curve showed that the AUC of serum H-FABP level at 3 days after PCI combined with R value, K value, α Angle and MA value in predicting prognosis of AMI patients was superior to that of a single diagnosis. Conclusion The serum H-FABP level is related to the prognostic effect of AMI patients after PCI. Combined with TEG-related parameters can improve the predictive value of poor prognosis in clinical practice. |
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