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投稿时间：2024-11-12 网络发布日期：2025-07-21
投稿时间：2024-11-12 网络发布日期：2025-07-21
中文摘要: 目的 探讨血清细胞外基质金属蛋白酶诱导因子（EMMPRIN）与急性ST段抬高型心肌梗死（STEMI）患者急诊经皮冠状动脉介入治疗（PCI）后心肌缺血再灌注损伤（MIRI）的关系。方法 入选2023年3月至2023年8月联勤保障部队第九二○医院就诊的STEMI患者195例，所有STEMI患者均完成冠状动脉造影微循环阻力指数（caIMR）测定，基于患者的MIRI程度，分为再灌注损伤轻组89例（caIMR≤40 u）和再灌注损伤重组106例（caIMR>40 u）。对照组纳入同期择期行冠脉造影后排除冠心病的患者44例。血清EMMPRIN采用ELISA法检测，用多因素二元logistic回归分析MIRI相关的独立危险因子；用受试者工作特征（ROC）曲线分析血清EMMPRIN水平对STEMI患者MIRI的诊断价值。结果 STEMI患者血清EMMPRIN表达水平显著高于对照组［（68.99±10.82）ng/L vs （48.26±7.95）ng/L，t=11.998，P<0.05］。再灌注损伤重组血清EMMPRIN表达水平显著高于再灌注损伤轻组［（74.25±9.48）ng/L vs （62.73±8.81）ng/L，t=8.734，P<0.05］。多因素logistic回归分析显示血清EMMPRIN是MIRI的独立危险因子（OR=1.14，95%CI：1.09~1.19，P<0.01）。ROC曲线分析显示EMMPRIN诊断MIRI的曲线下面积（AUC）为0.805，最佳截断值为71.51 ng/L，灵敏度为0.642，特异度为0.876。Spearman相关性分析显示血清EMMPRIN与MIRI程度呈正相关（r=0.480，P<0.01）。结论 血清EMMPRIN水平与MIRI程度呈正相关，对MIRI程度有一定预测价值。
Abstract:Objective To explore the relationship between extracellular matrix metalloproteinases inducer（EMMPRIN） and myocardial ischemia reperfusion injury（MIRI）inpatients with ST-segment elevation myocardial infarction（STEMI） after emergency percutaneous coronary intervention（PCI）. Methods A total of 195 patients with STEMI in the 920th Hospital of PLA Joint Logistics Support Force from March 2023 to August 2023 were enrolled. All STEMI patients completed coronary angiography microvascular resistance index（caIMR）measurement. The patients were divided into mild reperfusion injury group（caIMR≤40 u，n=89）and severe reperfusion injury group（caIMR>40 u，n=106）. At the same time，44 patients with who were excluded from coronary heart disease by coronary angiography were enrolled as control group. The serum EMMPRIN level was detected by enzyme-linked immunosorbent assay. Multivariate binary logistic regression was used to analyze the independent risk factors related to MIRI. ROC curve was used to analyze the diagnostic value of serum EMMPRIN level for MIRI in patients with STEMI. Results The expression of EMMPRIN in patients with STEMI was significantly higher than that in controls［（68.99±10.82）ng/L vs （48.26±7.95）ng/L，t= 11.998，P<0.05］. The expression of EMMPRIN in the severe reperfusion injury group was significantly higher than that in the mild reperfusion injury group［（74.25±9.48）ng/L vs （62.73±8.81）ng/L，t=8.734，P<0.05］. Multivariate logistic regression analysis showed that serum EMMPRIN was an independent risk factor for myocardial ischemia-reperfusion injury（ OR=1.14，95%CI：1.09-1.19，P<0.01）. ROC curve analysis showed that the area under the curve（AUC）of EMMPRIN was 0.805，the optimal cut-off value was 71.51 ng/L，the sensitivity was 0.642，and the specificity was 0.876. Spearman correlation analysis showed that serum EMMPRIN was positively correlated with the degree of MIRI （ r=0.480，P<0.01）. Conclusion The serum level of EMMPRIN is positively correlated with the degree of MIRI，and it has certain predictive value for the degree of MIRI.
keywords: Extracellular matrix metalloproteinases inducer ST-segment elevation myocardial infarction Myocardial ischemic reperfusion injury Coronary angiography Microvascular resistance index
文章编号： 中图分类号：R541 文献标志码：A
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引用文本：
王娜，陈长征，石燕昆，杨智华，樊君，杨丽霞.细胞外基质金属蛋白酶诱导因子与心肌缺血再灌注损伤的关系[J].中国临床研究,2025,38(7):1048-1051,1055.
王娜，陈长征，石燕昆，杨智华，樊君，杨丽霞.细胞外基质金属蛋白酶诱导因子与心肌缺血再灌注损伤的关系[J].中国临床研究,2025,38(7):1048-1051,1055.