2025 年第 1 期 第 0 卷

瘦素和鸢尾素对急性ST段抬高型心肌梗死患者左心室收缩功能的预测价值

Predictive value of leptin and irisin on left ventricular systolic function in patients with acute ST-segment elevation myocardial infarction

作者：王慧  时秀文  吕晓翠  李静  赵韩婷  治雅倩  程光慧

英文作者：Wang Hui Shi Xiuwen Lyu Xiaocui Li Jing Zhao Hanting Zhi Yaqian Cheng Guanghui

单位：河北北方学院附属第二医院心内科，张家口075100

英文单位：Department of Cardiology the Second Affiliated Hospital of Hebei North University Zhangjiakou 075100 China

关键词：急性ST段抬高型心肌梗死；  瘦素；  鸢尾素；  左心室收缩功能；  预测

英文关键词：AcuteST-segmentelevationmyocardialinfarction;  Leptin;  Irisin;  Leftventricularsystolicfunction;  Prediction

• 摘要：

• 目的  探究瘦素、鸢尾素对急性ST段抬高型心肌梗死（STEMI）患者左心室收缩功能（LVSF）的预测价值。方法  回顾性分析河北北方学院附属第二医院2021年1月至2024年1月收治的STEMI患者96例。将左心室射血分数（LVEF）＜50%的42例患者纳入观察组，LVEF≥50%的54例患者纳入对照组。分析STEMI患者瘦素、鸢尾素与左心室收缩末期周向室壁应力（cESS）和心肌能量消耗（MEE）的关系，并分析瘦素、鸢尾素与LVSF障碍风险的独立相关性。构建限制性立方样条模型分析STEMI患者瘦素、鸢尾素与LVSF障碍风险的剂量-反应关系。结果  多因素Logistic回归分析结果显示，瘦素与cESS、MEE呈正相关，鸢尾素与cESS、MEE呈负相关（均P＜0.001）。瘦素与LVSF障碍呈独立正相关，鸢尾素与LVSF障碍呈独立负相关（均P<0.05）。瘦素、鸢尾素与LVSF障碍风险存在非线性剂量-反应关系，当瘦素≤15 μg/L时，STEMI患者LVSF障碍风险随瘦素水平的升高而升高（比值比=1.517，95%置信区间：1.118~1.735，P<0.001）；当鸢尾素≥0.89 mg/L时，STEMI患者LVSF障碍风险随鸢尾素水平的降低而升高（比值比=-1.593，95%置信区间：-2.818~-1.326，P<0.001）。结论  瘦素与LVSF障碍呈独立正相关，鸢尾素与LVSF障碍呈独立负相关。瘦素、鸢尾素与LVSF障碍风险存在非线性剂量-反应关系，当瘦素≤15 μg/L时，STEMI患者LVSF障碍风险随瘦素水平的升高而升高；当鸢尾素≥0.89 mg/L时，STEMI患者LVSF障碍风险随鸢尾素水平的降低而升高。

• Objective  To investigate the predictive value of leptin and irisin for left ventricular systolic function (LVSF) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods   A retrospective analysis was conducted on 96 STEMI patients admitted to the Second Affiliated Hospital of Hebei North University from January 2021 to January 2024. Patients with left ventricular ejection fraction (LVEF)<50% were included in the observation group (n=42), and those with LVEF≥50% were included in the control group (n=54). The correlation between leptin, irisin, and circumferential end-systolic stress (cESS) as well as myocardial energy expenditure (MEE) in patients with STEMI was analyzed. The independent correlations between leptin, irisin, and the risk of LVSF impairment were analyzed. A restricted cubic spline model was established to analyze the dose-response relationship between leptin, irisin, and the risk of LVSF impairment in STEMI patients. Results   The results of multivariate Logistic regression analysis showed that a significant positive correlation was observed between leptin and cESS, MEE, while a significant negative correlation was found between irisin and cESS, MEE (all P<0.001). Leptin exhibited an independent positive correlation, while irisin showed an independent negative correlation with LVSF impairment (both P<0.05). There was a nonlinear dose-response relationship between leptin, irisin, and the risk of LVSF impairment. When leptin was ≤15 μg/L, the risk of LVSF impairment in STEMI patients increased with increasing leptin levels ［odds ratio (OR)=1.517,95% confidence interval (CI): 1.118-1.735, P<0.001］. When irisin was ≥0.89 mg/L, the risk of LVSF impairment in STEMI patients increased with decreasing irisin levels (OR=-1.593, 95%CI: -2.818 to -1.326, P<0.001). Conclusions   Leptin has an independent positive correlation with LVSF impairment, while irisin shows an independent negative correlation. There exists a nonlinear dose-response relationship between leptin, irisin, and the risk of LVSF impairment. Specifically, when leptin is ≤15 μg/L, the risk of LVSF impairment in STEMI patients increases with increasing leptin levels; conversely, when irisin is ≥0.89 mg/L, the risk of LVSF impairment increases with decreasing irisin levels.