目的:研究血管形成抑制素-2(VS-2)在心肌梗死患者慢性心衰的发生和预后评估中的应用价值.方法:选择研究对象197例,均为医院从2017年7月-2022年7月收治的心肌梗死患者.将其根据是否发生慢性心衰分为心衰组112例以及无心衰组85例.比较两组各项心功能指标以及血清VS-2水平,并予以Pearson相关性分析.此外,将心衰组患者按照预后结局的差异分为预后不良组35例及预后良好组77例.以单因素及多因素Logistic回归分析明确心肌梗死后慢性心衰预后不良与相关影响因素的关系.结果:心衰组LVEF及血清VS-2水平分别为(38.94±3.16)%、(12.46±2.40)pg/L,相较于无心衰组的(44.62±5.19)%、(22.58±3.61)pg/L 更低,而心衰组LVEDD、LVEDV 水平分别为(97.34±10.36)mm、(260.94±11.35)mL,相较于无心衰组的(62.58±3.78)mm、(223.16±10.17)mL更高(P<0.05).经Pearson相关性分析发现:心肌梗死慢性心衰血清VS-2水平与LVEF呈正相关关系,与LVEDD、LVEDV呈负相关关系(P<0.05).经单因素分析发现:年龄、高血压、糖尿病、心功能分级以及LVEF、LVEDD、LVEDV、VS-2水平均和心肌梗死后心力衰竭预后不良有关(P<0.05).经多因素Logistic回归分析发现:心肌梗死后心力衰竭预后不良影响因素涵盖下述8项:①年龄;②高血压;③糖尿病;④心功能分级Ⅳ级;⑤LVEF;⑥LVEDD;⑦LVEDV;⑧VS-2(P<0.05).结论:VS-2可能在心肌梗死患者慢性心衰的发展中起着关键性作用,且与患者预后密切相关,值得临床重点关注.
Objective:To study the application value of angiostatin-2(VS-2)in the occurrence and prognosis assessment of chronic heart failure in patients with myocardial infarction.Methods:A total of 197 patients with myocardial infarction admitted to the hospital from July 2017 to July 2022 were included in the study.They were divided into heart failure group(n=112)and non-heart failure group(n=85)according to whether chronic heart failure occurred.The cardiac function indexes and serum VS-2 levels were compared between the two groups,and Pearson correlation analysis was performed.In addition,the patients in the heart failure group were divided into poor prognosis group(n=35)and good prognosis group(n=77)according to the difference of prognosis outcome.Univariate and multivariate Logistic regression analysis was used to determine the relationship between poor prognosis and related factors in chronic heart failure after myocardial infarction.Results:LVEF and serum VS-2 levels in the HF group were(38.94±3.16)%and(12.46±2.40)pg/L,respectively,which were lower than those in the non-HF group(44.62±5.19)%and(22.58±3.61)pg/L.The levels of LVEDD and LVEDV were(97.34±10.36)mm and(260.94±11.35)ml,which were higher than those of the non-HF group(62.58±3.78)mm and(223.16±10.17)ml(P<0.05).Pearson correlation analysis showed that serum VS-2 level was positively correlated with LVEF,and negatively correlated with LVEDD and LVEDV(P<0.05).Univariate analysis showed that age,hypertension,diabetes,cardiac function grade,LVEF,LVEDD,LVEDV and VS-2 levels were all associated with poor prognosis of heart failure after myocardial infarction(P<0.05).Multivariate Logistic regression analysis showed that the influencing factors of poor prognosis of heart failure after myocardial infarction included the following 8 factors:① age;② Hypertension;③ Diabetes mellitus;④ Cardiac function grade Ⅳ;⑤ LVEF;⑥ LVEDD;⑦ LVEDV;⑧ VS-2(P<0.05).Conclusion:VS-2 may play a key role in the occurrence of chronic heart failure in patients with myocardial infarction,and is closely related to the prognosis of patients,which is worthy of clinical attention.