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目的:探讨γ谷氨酰转移酶(gamma-glutamyltransferase,GGT)对行急诊介入治疗的ST段抬高心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者的主要心脏不良事件(major adverse cardiac events,MACE)的预测作用。方法:STEMI并行急诊经皮冠脉介入治疗患者112例。收集入选患者的基本资料,检测血清GGT,住院期间及出院后每月定期随访MACE。分析GGT预测MACE的价值。结果:应用ROC曲线分析GGT对112例患者发生MACE的预测作用,随访30 d ROC曲线下面积(AUC)为0.576,P>0.05。3个月及6个月AUC分别为0.661和0.632,均P<0.05。得到的截断点为28.65 U/L。但GGT>28.65 U/L和GGT<28.65U/L两组间年龄存在统计学差异(P<0.01),不具可比性。对70岁及70岁以上患者进行分析时,在随访的30 d、3个月和6个月曲线下面积均<0.5,无预测价值。70岁以下患者,30 d、3个月和6个月时AUC分别为0.669,0.715和0.720,分别为P<0.05,P<0.01和P<0.01,得到的截断点为28.65 U/L。把70岁以下患者GGT水平以28.65 U/L为截断点分为两组,GGT>28.65 U/L与GGT<28.65U/L组30 d,3个月及6个月MACE发生率为(28%vs.10%,P<0.05),(47%vs.12%,P<0.01)以及(50%vs.15%,P<0.01)。在二项分类的多变量logistic回归分析中,GGT独立于年龄、性别、多支病变、心功能KillipⅡ级以上、前壁心肌梗死、血清肌酸激酶同工酶、左室射血分数预测3个月、6个月MACE发生(均P<0.01)。结论:GGT对行急诊介入治疗的年龄70岁以下STEMI患者预后有预测价值。
Objective: To investigate the effect of gamma glutamyltransferase (GGT) on major adverse cardiac events (STEMI) in patients undergoing STEMI. MACE) the predictive role. Methods: One hundred and twelve patients with STEMI concurrent percutaneous coronary intervention. Basic information on selected patients was collected, serum GGT was measured, and monthly regular follow-up MACE during hospitalization and after discharge. Analyze the value of GGT forecast MACE. Results: The ROC curve of GGT was used to predict the MACE in 112 patients. The area under the curve of ROC at 30 days after follow-up was 0.576, and the AUC of P> 0.05 for 3 months and 6 months were 0.661 and 0.632 <0.05. The cut-off point is 28.65 U / L. However, the GGT> 28.65 U / L and GGT <28.65 U / L between the two groups there is a statistically significant difference (P <0.01), not comparable. When analyzing patients aged 70 and over, the area under the curves at 30 d, 3 and 6 months of follow-up were all <0.5, with no predictive value. AUC of 0.669, 0.715 and 0.720 at 30 d, 3 and 6 months respectively were P <0.05, P <0.01 and P <0.01, respectively. The cut-off point was 28.65 U / L. The GGT levels of patients under 70 years old were divided into two groups with 28.65 U / L as cut-off points. The incidence of MACE at 3 months and 6 months after GGT> 28.65 U / L and GGT <28.65 U / L was 28 days % vs.10%, P <0.05), (47% vs.12%, P <0.01) and (50% vs.15%, P <0.01). In the multivariate logistic regression analysis of the two categories, GGT was independent of age, gender, multivessel disease, cardiac function above Killip class II, anterior myocardial infarction, serum creatine kinase isoenzyme, left ventricular ejection fraction 3 Month, MACE occurred 6 months (all P <0.01). Conclusion: GGT has predictive value for the prognosis of STEMI patients under 70 years of age who underwent emergency intervention.