血清骨保护素与急性ST段抬高型心肌梗死患者院内主要不良心血管事件的相关性
Association between serum osteoprotegerin and in hospital major adverse cardiac events in patients with acute ST segment elevation myocardial infarction

杨璐瑜.血清骨保护素与急性ST段抬高型心肌梗死患者院内主要不良心血管事件的相关性[J].内科急危重症杂志,2017,23(6):478-481

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DOI：10.11768/nkjwzzzz20170611

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基金项目:武汉市卫生计生委基金项目（No:WX16C04）; 武汉市卫生计生委基金项目（No: WX16C07）

作者	单位	E-mail
杨璐瑜	武汉市第三医院	fszfsz181@163.com

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中文摘要:

目的：探讨急性ST段抬高型心肌梗死（STEMI）患者血清骨保护素（OPG）水平与其院内主要不良心血管事件（MACE）的相关性。方法：340例接受急诊经皮冠状动脉介入治疗的STEMI患者，根据是否发生院内MACE分为MACE组（58例）和非MACE组（282例）。采用ELISA法测定患者入院时的血清OPG水平。结果：MACE组患者的血清OPG水平显著高于非MACE组 \[（2.4 ± 0.5）ng/mL vs （1.6± 0.3）ng/mL，P<0.01\]。随着OPG水平的升高，MACE发生率也逐渐增加（P<0.05）。多因素Logistic回归分析表明，OPG水平是STEMI患者发生院内MACE的独立预测因素（OR 2.18, 95% CI 1.36~3.49,P<0.01）。ROC曲线分析提示，OPG预测院内MACE发生的最佳截点为1.68ng/mL，其敏感性为68%，特异性为78%。结论：STEMI患者的血清OPG水平与院内MACE的发生密切相关，且高血清OPG水平是其发生院内MACE的独立危险因素。

英文摘要:

Objective: To investigate the relationship between serum osteoprotegerin (OPG) level and in-hospital major adverse cardiac events (MACE) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: A total of 340 patients with STEMI receiving primary percutaneous coronary intervention were included. According to the presence or absence of in-hospital MACE, these patients were divided into the MACE (n=58) and non-MACE (n=282) groups. The serum OPG level at admission was measured by ELISA method. Results: Patients in the MACE group showed a significantly higher level of OPG than in the non-MACE group \[(2.4 ± 0.5) ng/mL vs (1.6 ± 0.3) ng/mL, P<0.01\]. The occurrence rate of MACE was significantly increased along with the elevated OPG level (P<0.05). Multivariate logistic regression analysis indicated that OPG was an independent predictor of in-hospital MACE in STEMI patients (OR 2.18, 95% CI 1.36~3.49, P<0.01). ROC curve analysis showed that the optimal cut-off value of OPG for predicting in-hospital MACE was 1.68ng/mL, with a sensitivity of 68% and a specificity of 78%. Conclusion: In patients with STEMI, serum level of OPG is closely associated with the occurrence of in-hospital MACE. The elevated OPG level is an independent risk factor of in-hospital MACE in STEMI patients.