心脑血管病防治2025，Vol.25Issue(9)：36-40,5.DOI:10.3969/j.issn.1009-816x.2025.09.008
急性心肌梗死患者血清间α-胰蛋白酶抑制剂重链、前蛋白转化酶枯草杆菌蛋白酶kexin-9水平及临床意义
Serum levels and clinical significance of inter-alpha-trypsin inhibitor heavy chain and preprotein convertase subtilisin/kexin type 9 in patients with acute myocardial infarction
摘要
Abstract
Objective To investigate the serum expression levels and clinical significance of inter-alpha-trypsin inhibitor heavy chain(ITIH)and preprotein convertase subtilisin/kexin type 9(PCSK9)in patients with acute myocardial infarction(AMI).Methods From December 2020 to January 2023,85 AMI patients admitted to the Hospital of Xinjiang University of Finance and Economics were collected as the AMI group.Fifty healthy volunteers who underwent routine health examinations at the hospital during the same period were recruited as the control group.AMI patients were followed up for one year.Based on the occurrence of major adverse cardiovascular events(MACE)in their prognosis,AMI patients were separated into a MACE group(48 cases)and a non-MACE group(37 cases).Clinical data from all subjects were collected and analyzed.Serum levels of ITIH and PCSK9 were compared between the MACE group and the non-MACE group.Pearson method was applied to analyze the correlation between serum ITIH and PCSK9,and their correlation with cardiac troponin I(cTnI),creatine kinase-MB(CK-MB),B-type natriuretic peptide(BNP),and N-terminal pro-B-type natriuretic peptide(NT-proBNP).Multivariate Logistic regression was applied to analyze the influencing factors for AMI occurrence.ROC curve was applied to analyze the predictive value of serum levels of ITIH and PCSK9 for MACE occurrence in AMI patients.Results Compared with the control group,the levels of CTnI,CK-MB,BNP,NT-proBNP,and serum PCSK9 in the AMI group was significantly higher(t=19.518,11.504,18.706,53.901,7.542;P<0.05),while the serum level of ITIH were lower(t=8.350,P<0.05).Pearson's correlation analysis revealed that serum ITIH level was negatively correlated with cTnI,CK-MB,BNP,and NT-proBNP in patients with AMI,while serum PCSK9 level was positively correlated;the serum ITIH level was negatively correlated with PCSK9 level(P<0.05).Multivariate Logistic regression analysis revealed that serum ITIH,PCSK9,CTnI,and BNP were influencing factors for AMI(OR=0.986,1.065,1.365,1.376;P<0.05).Compared with the non-MACE group,the serum level of ITIH in the MACE group was significantly lower,and the serum level of PCSK9 was higher(t=6.837,6.319;P<0.05).ROC curve analysis revealed that both serum ITIH and PCSK9 exhibited predictive value for MACE in AMI patients,and their combined predictive value was higher(Z=4.996,3.615;P<0.05).Conclusion Serum ITIH level is decreased,while PCSK9 level is elevated in AMI patients,and a negative correlation is observed between them.Both biomarkers demonstrate predictive value for MACE in AMI patients,and their combination shows superior predictive performance.关键词
急性心肌梗死/间α-胰蛋白酶抑制剂重链/前蛋白转化酶枯草杆菌蛋白酶kexin-9/主要不良心血管事件Key words
Acute myocardial infarction/Inter-alpha-trypsin inhibitor heavy chain/Proprotein convertase subtilisin/kexin type 9/Major adverse cardiovascular events引用本文复制引用
李媛媛,薄涛,徐洁..急性心肌梗死患者血清间α-胰蛋白酶抑制剂重链、前蛋白转化酶枯草杆菌蛋白酶kexin-9水平及临床意义[J].心脑血管病防治,2025,25(9):36-40,5.基金项目
新疆维吾尔自治区自然科学基金资助项目(2022D01C324) （2022D01C324）
