血浆血管性血友病因子抗原水平对老年急性心肌梗死 患者长期预后的预测价值

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中图分类号：R541.4 文献标志码：A DOI：10.11958/20250518

Abstract：ObjectiveTo investigate the predictive valueofplasmavon Willbrand factor（VWF）antigen levels forthe long-termprognosisofpatientswithacutemyocardialinfarction（AMI）.MethodsAtotalof15Oelderlypatientsdiagnosed with AMI were selectedand treated with percutaneous coronary intervention （PCI）at admission.The plasma VWFantigen levelof the patients was detected within24 hoursafterPCI.Patientswerefollowedupfor12 monthsandweredivided into the major adverse cardiac events （MACE） group and the non-MACE group according to the occurrence of MACE.The risk factors for MACE inAMI patients within12 monthswere analyzed.The prognostic valueof VWFantigen level in AMI patientswereevaluated.Theoptimal cut-off valueof plasma VWFantigen level was determined byreceiveroperating characteristic （ROC）curve.Patients were groups according to theoptimal cut-offvalue.Kaplan-Meiercurve was drawn to compare theoccurrenceof MACE inpatientswith diffrentplasmaVWFantigen levels.ResultsAmong the15Oobserved patients，7patients werelosttofolow-up，andeventually143 patients were included.In143 patients there were53 patients （204号 （37.1%） in the MACE group and 90 cases （63.9% ） in the non-MACE group. The age， B-type natriuretic peptide （BNP）， Ddimerand VWFantigenlevels weresignificantlyhigherintheMACE groupthanthose inthenon-MACE group.Theresults of the Cox proportional hazards model showed that age increase （ HR=1.085 ， 95%CI ： 1.014-1.160）， increased plasma VWF antigen level（HR=1.030，95%CI： 1.017-1.045）and increasedBNP（HR=1.016，95%CI： 1.004-1.027）were risk factors for elderly patients in the MACE grouponeyear after surgery.The maximumapproximately Youden index of plasma VWF antigen level for predicting MACE was O.616，the optimal cut-off value was 162.5μg/L ，the sensitivity was 84.9% and the specificity was 76.7% .The results of survival analysis showed that the average time to MACE in the group with plasma VWF antigen ⩾162.5μg/L was shorter than that in the group with plasmaVWF antigen <162.5μg/L （7.7 months us. 11.6 months， Log-rank χ2 =63.060， P<0.001 ）.ConclusionThe increased plasma VWF antigen is an independent risk factor for AMI and can be used as a predictor of long-term prognosis in patients with AMI.

KeyWords：myocardial infarction;risk factor; von Willebrand factor; major adverse cardiac events

冠状动脉粥样硬化性心脏病是常见的心血管疾病，患病率和死亡率在我国呈不断上升的趋势[1-2]。（剩余7355字）