| Objective: By comparing the distribution differences of PLA2 and FT3 in the control group,the myocardial infarction group and the myocardial infarction combined with heart failure group,as well as the correlation between the two and other inflammatory indexes,the predictive value of PLA2 and FT3 combined detection for heart failure after myocardial infarction was comprehensively evaluated.Methods: Patients admitted to the Department of Cardiology of the Affiliated Hospital of Yan ’an University from December 2019 to December 2020 who met the diagnostic criteria and exclusion criteria and underwent emergency PCI were selected as the observation group.At the same time,patients admitted at the same period who underwent coronary CTA showing major coronary stenosis were selected.A total of 148patients(50%)were enrolled as the control group.A total of 152 patients with MI were enrolled as the observation group.According to the comprehensive situation of patients,cardiac function grading(Killip grading)was performed,and 74 patients in the Killip grading 2 group were MI+HF group.KILLIP class 1 for MI group,a total of 78 patients with collecting all the general information,all of the patients with acute myocardial infarction(MI)in hospital: ecg examination,check and urgent myocardial injury kidney function setting the BNP blood routine examination,blood extract fasting blood samples on the morning of the next day,line general routine examination and serum lipoprotein associated phospholipase A2,we check,all the patients with myocardial infarction were recorded in 2,adept bedside echocardiography,normal control group patients cardiac ultrasound The collected data for statistical processing,draw the conclusion.Results:1.By analyzing the discovery history of diabetes in the distribution of the overall difference between three groups was statistically significant(P = 0.032),respectively three group of diabetes history than MI + HF(25.7%),MI group(21.8%)and control group(14.2%),Multiple comparisons showed that the composition ratio of diabetes history in MI+HF group and MI group was significantly higher than that in the control group(P<0.05);There was no statistical significance in gender,smoking history and hypertension history among the three groups(P>0.05).2.Pair comparison of hs-CRP,PA,TG,LDL and Pro-BNP showed statistically significant difference in the distribution of MI+HF group,MI group and control group(P<0.05).Comparison of hs-CRP,TG,LDL and Pro-BNP among three groups showed that MI+HF group >MI group > control group,PA showed that MI+HF group <MI group< control group.The overall difference in age and LVEF value distribution was statistically significant(P<0.05).When pairwise comparison was made,age of MI+HF group >MI group、control group;In terms of LVEF value,the MI+HF group<MI group 、control group.The overall differences of NEU,WBC,HDL,c Tn I and TSH were statistically significant(P<0.05).When multiple comparisons were made,there were statistically significant differences that MI+HF group and MI group in NEU,WBC and c Tn I> control group(P<0.05),but there were no significant differences in NEU,WBC,c Tn I between MI+HF group and MI group(P>0.05).HDL and TSH in MI+HF group and MI group were lower than those in control group(P<0.05),while HDL and TSH in MI group and MI+HF group were not significantly different(P>0.05).The TC,FIB,T4 and FT4 of MI+HF group,MI group and control group were not significantly different(P>0.05).3.The distribution of PLA2,FT3 and T3 among the three groups was shown:control group >MI group > MI+HF group in FT3 and T3(P<0.05),and control group <MI group<MI+HF group in PLA2(P<0.05).4.The correlation analysis between FT3 and other indicators of all subjects was found:FT3 was positively correlated with T3,EF and PA(r = 0.386,0.426,0.378,P <0.001),Was significantly negatively correlated with Pro-BNP,hs-CRP,Neu and TG(r =-0.586,-0.453,-0.362,-0.217,P < 0.001),LDL(r=-0.143,P=0.013)and HDL(r=0.116,P=0.044),There was no correlation with TSH(P>0.05).5.Correlation analysis of PLA2 and other indexes in all subjects showed that PLA2 was positively correlated with Pro-BNP,hs-CRP,Neu and WBC(r = 0.521,0.548,0.366,0.358,all P < 0.001).Was significantly negatively correlated with PA and EF(r =-0.406and-0.489,P < 0.001).There was no correlation with TSH(P>0.05).6.There was a negative correlation between PLA2 and FT3(r=-0.679,P=0.000).7.The ROC curve was used to evaluate the predictive value of FT3 and PLA2 in predicting heart failure after myocardial infarction.The AUC of FT3 was 0.811(P<0.001),when the cut-off value was 4.26pmol/L,the sensitivity and specificity were84.5% and 71.6%,95%CI(0.744-0.879).The AUC for PLA2 independent prediction was0.801(P<0.001),when the cut-off value was 141ug/ml,the sensitivity and specificity were 71.6% and 70.8%,95%CI(0.736-0.866).The AUC of the combined detection was increased to 0.820(P<0.001).Conclusion:1.When FT3 < 4.26pmol/L and PLA2 > 141ug/ml,patients with acute myocardial infarction were more likely to develop heart failure,and the combined detection value of the two was higher than that of single detection.2.The relationship between serum FT3 and PLA2 and heart failure after myocardial infarction is close,which can provide a new idea for clinical diagnosis and treatment. |
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