摘要： 目的 探讨血浆γ-谷氨酰转移酶（GGT）与ST段抬高型急性心肌梗死（STEMI）患者直接经皮冠状动脉介入治疗（PCI）术后发生无复流现象和预后的关系。方法 连续纳入2017年1月至2018年12月就诊于我院行直接PCI的STEMI患者共390例。根据我院GGT值正常参考值上限，将STEMI患者分为正常GGT组（GGT≤64 U/L）和高GGT组（GGT>64 U/L）。比较2组患者直接PCI术后无复流现象以及12个月内主要不良心血管事件（MACE）的发生。结果 与正常GGT组相比，高GGT组无复流的发生率更高。logistic多因素回归分析结果显示，GGT>64 U/L是无复流的独立预测因子（OR=2.34，95%CI：1.04~5.27，P=0.039）。Kaplan-Meier生存曲线分析发现高GGT组患者发生MACE和全因死亡要高于正常GGT组，但2组在新发心力衰竭和再次血运重建间方面无统计学差异。高GGT组患者术后12个月内发生MACE的风险是正常GGT组患者的2.38倍（HR=2.38，95%CI：1.12~5.05，P=0.023），发生全因死亡的风险是正常GGT组患者的3.87倍（HR=3.87，95%CI：1.10~13.60，P=0.035）。结论 升高的血清GGT值对STEMI患者直接PCI术后无复流现象和12个月内MACE发生具有独立预测价值。

γ-谷氨酰转移酶对急性心肌梗死患者PCI术后无复流及预后的预测价值

胡美荣, 张嵚垚, 杨智勇

中国医科大学附属盛京医院心血管内科, 沈阳 110004

收稿日期:2020-08-31出版日期:2021-08-30发布日期:2021-07-29
通讯作者:杨智勇E-mail:2979089939@qq.com
作者简介:胡美荣(1993-),女,硕士研究生.



关键词: γ-谷氨酰转移酶, ST段抬高型急性心肌梗死, 无复流现象, 预后
Abstract: Objective To investigate the relationship between plasma γ-glutamyltransferase (GGT) levels and the occurrence of no-reflow phenomenon and patients’ prognosis after primary percutaneous coronary intervention (PCI) for ST-segment elevation acute myocardial infarction (STEMI). Methods Patients with STEMI who underwent PCI in this hospital from January 2017 to December 2018 were enrolled. According to the upper limit of normal reference values for GGT in this hospital,the patients were divided into normal GGT (GGT ≤ 64 U/L) and high GGT (GGT > 64 U/L) groups. The incidence of no-reflow phenomenon and major adverse cardiovascular events (MACEs) within 12 months after PCI was compared between the two groups. Results A total of 390 patients were included. The incidence of no-reflow phenomenon was higher in the high GGT than in the normal GGT group. Logistic multivariate regression analysis showed that a GGT level of >64 U/L was an independent predictor of no-reflow phenomenon (OR = 2.34,95% CI:1.04-5.27,P = 0.039). The Kaplan-Meier survival analysis showed a higher incidence of MACEs and all-cause mortality in the high GGT group,but there was no difference between the two groups in the incidence of new heart failure and revascularization. Moreover,compared with the normal GGT group,the high GGT group had 2.38 times higher risk of MACEs (HR=2.38,95% CI:1.12-5.05,P = 0.023) and 3.87 times higher risk of all-cause mortality (HR=3.87,95% CI:1.10-13.60,P = 0.035) within 12 months after primary PCI. Conclusion In patients with STEMI undergoing primary PCI,high GGT levels at admission can independently predict the occurrence of no-reflow phenomenon and MACEs within 12 months.
Key words: γ-glutamyl transferase, ST segment elevation acute myocardial infarction, no reflow phenomenon, prognosis
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