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目的:研究血浆髓过氧化物酶(MPO)水平对急性心肌梗死(AMI)患者预后的影响和预测价值。方法:入选AMI患者共71例,于入院即刻采用比色法测血浆MPO水平;同时测CK-MB、cTNT、hs-CRP、WBC、N;按MPO水平行二分位数分组。行30、90d随访,以缺血性胸痛、非致命性心肌梗死、心力衰竭、心血管原因的再住院、心血管原因的死亡为终点事件。结果:MPO≥125.86U/L组的30d终点事件发生率明显高于MPO<125.86U/L组(OR4.00,95%CI[1.06,16.38],P=0.04);90d终点事件发生率亦明显高于MPO<125.86U/L组(OR3.88,95%CI[1.09,13.77],P=0.03)。MPO水平与WBC、N正相关,和cTNT、CK-MB、hs-CRP无相关性。回归分析,MPO和cTNT峰值是30d发生终点事件的危险因素(MPO:B=1.83,P=0.03;cTNT:B=0.38,P=0.01);cTNT峰值、MPO和hs-CRP是90d发生终点事件的危险因素(MPO:B=1.92,P=0.02;cTNT峰值:B=0.42,P=0.01;hs-CRP:B=0.15,P=0.04)。结论:血浆MPO水平升高的AMI患者随访30、90d的终点事件发生率明显增高,血浆MPO水平对AMI患者的预后有独立的预测价值。
Objective: To study the effect of plasma levels of myeloperoxidase (MPO) on the prognosis of patients with acute myocardial infarction (AMI) and its prognostic value. Methods: A total of 71 AMI patients were enrolled in this study. Plasma MPO level was measured by colorimetric method immediately after admission. CK-MB, cTNT, hs-CRP, WBC and N were measured at the same time. Follow-up for 30 and 90 days included ischemic chest pain, non-fatal myocardial infarction, heart failure, cardiovascular rehospitalization, and cardiovascular death. Results: The incidence of end-point events at 30 days in MPO≥125.86U / L group was significantly higher than that in MPO <125.86U / L group (OR4.00,95% CI [1.06,16.38], P = 0.04) Significantly higher than MPO <125.86U / L group (OR 3.88, 95% CI [1.09, 13.77], P = 0.03). The level of MPO was positively correlated with WBC and N, but not with cTNT, CK-MB and hs-CRP. Regression analysis showed that the peak of MPO and cTNT were the risk factors for the end point of 30 days (MPO: B = 1.83, P = 0.03; cTNT: B = 0.38, P = 0.01); cTNT peak, MPO and hs- (MPO: B = 1.92, P = 0.02; cTNT peak: B = 0.42, P = 0.01; hs-CRP: B = 0.15, P = 0.04). CONCLUSION: The incidence of end-point events in AMI patients with elevated MPO levels at 30 and 90 days of follow-up was significantly higher. The plasma MPO level had independent predictive value for the prognosis of AMI patients.