Objective To study the predictive value of soluble ST2 for heart failure after AMI. Methods Fifty STEMI patients underwent percutaneous coronary intervention(PCI)were enrolled. The serum level of NT-proBNP and sST2 was assayed within 24 hours after admission. LVEF was measured by Echo one week after PCI. Patients were divided into heart failure group and non systolic heart failure group according to LVEF45%. The general clinical features and NT-ProBNP,sST2 and other biological markers were compared between the two groups. The predictors for heart failure in STEMI patients during hospitalization were analyzed by linear regression. Results The concentration of serum sST2 in heart failure group was 59.17pg/ml,which was significantly higher than that in non-heart failure group(35.65 pg/ml). NT-proBNP level and the time from onset to balloon time (OtoB)were also statistically different between two groups. Taking the median sST2 value(38.16pg/ml)as the boundary point,STEMI patients were also divided into higher sST2 group and lower sST2 group. The incidence of heart failure in higher sST2 group was 52%,which was significantly higher than that in lower sST2 group. Multivariate linear regression analysis showed that sST2 and NT-proBNP were both independent risk factors for heart failure after STEMI. Conclusion sST2 and NT-proBNP are both predictors of heart failure during hospitalization after STEMI.%目的 探讨可溶性ST2(sST2)对急性ST段抬高心肌梗死(STEMI)患者住院期间心力衰竭发生的预测价值.方法 选择行急诊冠状动脉介入治疗的STEMI患者50例,收集一般临床资料,检测血糖,血脂等生化指标,免疫定量分析仪胶体金法测量脑钠肽前体.采集入院24h内肘静脉血,保存血清,酶联免疫吸附法统一测量sST2浓度.入院后1周左右,行心超检查,测量左心室射血分数(LVEF)等指标.以LVEF45% 为分界将患者分为收缩性心力衰竭组与非收缩性心力衰竭组.比较两组一般临床特征及NT-ProBNP、sST2等生物学标志物;线性回归分析STEMI患者住院期间心力衰竭发生的预测因子.结果 心力衰竭组血清sST2浓度为59.17pg/ml,其明显高于非心力衰竭组35.65pg/ml,差异有统计学意义(t=5.82,P<0.01).两组NT-proBNP浓度及发病至血管开通时间(OtoB),差异有统计学意义.以整个研究人群sST2的中位数值38.16pg/ml为分界点,将STEMI患者分为高sST2组和低sST2组,高sST2组心力衰竭发生率52%,明显高于低sST2组的心力衰竭发生率4%,差异有统计学意义(χ2=14.286,P<0.01).多元线性回归分析发现,sST2及NT-proBNP为STEMI的独立危险因素,两者回归标准化系数接近,分别为-0.50和-0.49.结论 sST2与NT-proBNP均是STEMI患者住院期间心力衰竭发生的预测因子.
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