摘要目的:分析急性ST段抬高型心肌梗死（STEMI）患者血清视黄醇结合蛋白4（RBP4）、超氧化物歧化酶（SOD）、超敏C -反应蛋白（hs-CRP）的表达及临床意义。方法:选取2017年1月至2019年3月广西壮族自治区南溪山医院确诊STEMI并行急诊经皮冠状动脉介入治疗（PCI）的78例患者作为研究对象。在常规治疗基础上，给予阿托伐他汀钙或瑞舒伐他汀钙治疗；同时根据冠状动脉（冠脉）造影结果分为单支、双支、三支血管病变组，均进行冠脉病变程度评分（SYNTAX评分）。检测并比较各组患者治疗前后血清RBP4、SOD和hs-CRP水平。记录并比较不同组间STEMI患者血清学指标与SYNTAX评分、风险预测（即STEMI高危评分）及预后的相关性。结果:治疗前，各组患者血清RBP4、SOD和hs-CRP水平差异无统计学意义。多支（双支及三支）血管病变组中，SYNTAX评分与RBP4、hs-CRP显著相关（双支病变： r值分别为0.616、0.489，三支病变： r值分别为0.423、0.357，均 P<0.05），而与SOD无相关性（ r值分别为0.108、0.055，均 P0.05）；且高危评分与RBP4、hs-CRP水平密切相关（ r值分别为0.581、0.623，均 P<0.01）。使用不同他汀类药物对患者预后的影响差异无统计学意义，阿托伐他汀钙组和瑞舒伐他汀钙组高危患者分别有8例、7例，死亡患者分别有2例、3例（均 P>0.05）。 结论:联合检测血清RBP4、SOD及hs-CRP水平可以作为较好的指标来预测STEMI的发病风险，值得临床推广。

abstractsObjective:To analyze the expression and clinical significance of serum retinol binding protein 4 (RBP4), superoxide dismutase (SOD) and hypersensitive C-reactive protein (hs-CRP) in patients with acute ST-segment elevated myocardial infarction (STEMI).Methods:Seventy-eight patients with STEMI who underwent percutaneous coronary intervention (PCI) admitted to Nanxishan Hospital of Guangxi Zhuang Autonomous Region from January 2017 to March 2019 were enrolled. On the basis of the routine treatment, atorvastatin calcium or rosuvastatin calcium treatment was given. According to the results of coronary angiography, the patients were divided into three groups: single-vessel, double-vessel and three-vessel lesions, and the severity of coronary artery disease score (SYNTAX score) was performed. The serum RBP4, SOD and hs-CRP were measured and compared among different groups before and after treatment. The correlation between the three serum parameters of STEMI patients and the SYNTAX score, risk prediction (STEMI high-risk score) and prognosis were recorded and compared among different groups.Results:There was no significant difference in serum RBP4, SOD and hs-CRP among different groups before treatment. In multivessel (double-vessel and three-vessel) vascular disease group, SYNTAX score was significantly correlated with RBP4 and hs-CRP (double-vessel lesions: r values were 0.616 and 0.489 respectively, three-vessel lesions: r values were 0.423 and 0.357 respectively, all P < 0.05), but had no correlation with SOD ( r values were 0.108 and 0.055 respectively, both P > 0.05), and high-risk score was closely correlated with RBP4 and hs-CRP levels ( r values were 0.581 and 0.623 respectively, both P < 0.01). There was no significant difference in the prognosis of patients treated with different statins. There were 8 and 7 high-risk patients in the atorvastatin calcium group and rosuvastatin calcium group, respectively, and 2 and 3 dead patients respectively (both P > 0.05). Conclusion:Combined detection of serum RBP4, SOD and hs-CRP levels can be used as better indicators to predict the risk of STEMI, which is worthy of clinical application.