血浆中性粒细胞明胶酶相关脂质运载蛋白、基质金属蛋白酶-9、白细胞介素-1β、高敏C反应蛋白水平可有效评估急性ST段抬高型心肌梗死危险分层

赵荣荣.血浆中性粒细胞明胶酶相关脂质运载蛋白、基质金属蛋白酶-9、白细胞介素-1β、高敏C反应蛋白水平可有效评估急性ST段抬高型心肌梗死危险分层[J].内科急危重症杂志,2025,31(6):554-558

DOI：10.11768/nkjwzzzz20250614

中文关键词: 急性ST段抬高型心肌梗死中性粒细胞明胶酶相关脂质运载蛋白基质金属蛋白酶-9 白细胞介素-1β 高敏C反应蛋白

英文关键词:

基金项目:

作者	单位	E-mail
赵荣荣	张家口市第一医院	pieji1992@163.com

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中文摘要:

摘要目的：观察急性ST段抬高型心肌梗死（STEMI）患者血浆中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、基质金属蛋白酶-9（MMP-9）、白细胞介素-1β（IL-1β）、高敏C反应蛋白（hs-CRP）水平，并分析其与危险分层的相关性及评估价值。方法：选取急性STEMI患者100例作为急性STEMI组，同期稳定型心绞痛（SAP）患者100例作为SAP组，另选取同期健康体检者100例作为对照组。比较3组血浆NGAL、MMP-9、IL-1β、hs-CRP水平。急性STEMI组患者再根据SYNTAX积分分为高危组（25例），中危组（44例），低危组（31例），比较急性STEMI组不同危险分层患者血浆NGAL、MMP-9、IL-1β、hs-CRP水平。采用Pearson相关系数分析其与SYNTAX积分相关性；采用受试者工作特征（ROC）曲线分析血浆NGAL、MMP-9、IL-1β、hs-CRP对急性STEMI危险分层的评估价值。结果：急性STEMI组血浆NGAL、MMP-9、IL-1β、hs-CRP水平高于SAP组和对照组，且SAP组高于对照组（P均＜0.05）；高危组患者血浆NGAL、MMP-9、IL-1β、hs-CRP水平高于中危组和低危组，且中危组高于低危组（P均＜0.05）；血浆NGAL、MMP-9、IL-1β、hs-CRP与SYNTAX积分呈正相关（P均＜0.05）；NGAL、MMP-9、IL-1β、hs-CRP鉴别评估低危与中危的曲线下面积（AUC）分别为0.847、0.748、0.662、0.679，鉴别评估低危中危与高危的AUC分别为0.850、0.773、0.693、0.673，且NGAL鉴别评估的AUC最大（P均＜0.05）。结论：急性STEMI患者血浆NGAL、MMP-9、IL-1β、hs-CRP水平升高与急性STEMI危险分层具有相关性，对急性STEMI危险分层具有评估价值。

英文摘要:

Abstract Objective: To observe the levels of neutrophil gelatinase-associated lipocalin (NGAL), matrix metalloproteinase-9 (MMP-9), interleukin-1β (IL-1β), and high-sensitivity C-reactive protein (hs-CRP) in plasma of patients with acute ST-segment elevation myocardial infarction (STEMI), and to compare and analyze their correlation with risk stratification and evaluation value. Methods: A total of 100 acute STEMI patients were selected as the acute STEMI group, 100 stable angina pectoris (SAP) patients were selected as the SAP group, and 100 health check-up participants during the same period were selected as the control group. The levels of plasma NGAL, MMP-9, IL-1β, and hs-CRP were compared among the three groups. The levels of plasma NGAL, MMP-9, IL-1β, and hs-CRP were compared in patients with different risk stratifications in the acute STEMI group. Pearson correlation coefficient was used to analyze the correlation between SYNTAX score and the above factors. The value of plasma NGAL, MMP-9, IL-1β, and hs-CRP in risk stratification of acute STEMI was evaluated using receiver operating characteristic (ROC) curve analysis. Results: The plasma levels of NGAL, MMP-9, IL-1β, and hs-CRP in the acute STEMI group were higher than those in the SAP group and the control group, and those in the SAP group were higher than the control group (all P< 0.05); the plasma levels of NGAL, MMP-9, IL-1β, and hs-CRP in high-risk individuals were higher than those in moderate and low-risk individuals, and those in the moderate risk individuals were higher than the low-risk individuals (all P< 0.05); Plasma NGAL, MMP-9, IL-1β, hs-CRP were positively correlated with SYNTAX score (all P< 0.05); the area under the curve (AUC) of NGAL, MMP-9, IL-1β, and hs-CRP for distinguishing low-risk from moderate risk were 0.847, 0.748, 0.662, and 0.679, respectively. The AUC for distinguishing low-risk from moderate risk and high-risk were 0.850, 0.773, 0.693, and 0.673, respectively. Moreover, the AUC of NGAL for distinguishing low-risk from moderate risk and low-risk from moderate risk was significantly higher than that of MMP-9, IL-1β, and hs-CRP (all P< 0.05). Conclusions: The elevated levels of plasma NGAL, MMP-9, IL-1β, and hs-CRP in acute STEMI patients are correlated with acute STEMI risk stratification and have evaluative value for acute STEMI risk stratification.