目的 研究急性心肌梗死（acute myocardial infarction，AMI）后心力衰竭（heart failure，HF）患者血清可溶性生长刺激表达因子2（soluble growth stimulation expressed gene 2，sST2）、氨基末端B型脑钠肽前体（n-terminal pro-brain natriuretic peptide，NT-proBNP）及超声心动图参数与心肌重塑的关联性。 方法 选取2023年1月至2024年1月期间本院收治的120例AMI后HF患者，根据随访6个月期间超声心动图结果分为心肌重塑组和非心肌重塑组。比较两组血清sST2、NT-proBNP及超声心动图参数，分析其对心肌重塑的预测价值。 结果 根据Killip心力衰竭分级将患者分为3组，3组sST2、NT-proBNP、左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心房内径（LAD）比较，Killip Ⅱ级组 < Killip Ⅲ级组 < Killip Ⅳ级组，差异有统计学意义（P < 0.05）；3组左室射血分数（LVEF）比较，Killip Ⅱ级组 > Killip Ⅲ级组 > Killip Ⅳ级组，差异有统计学意义（P < 0.05）；多因素分析结果显示，sST2高、NT-proBNP高、LAD高是AMI后HF患者发生心肌重塑的独立危险因素（P < 0.05）；ROC曲线显示，列线图模型的曲线下面积（AUC）为0.82（95%CI： 0.71 ~ 0.92）。对模型进行Hosmer-Lemeshow拟合优度检验，认为拟合的概率值和实际的概率值基本一致（χ² = 3.67，P = 0.801），进一步通过Bootstrap重复抽样1 000次后绘制校准曲线，发现校准曲线与实际曲线一致性良好，且均接近理想曲线。决策曲线显示患者净获益均比另外两条极端曲线高，且阈值概率在0.16 ~ 0.94时，模型能产生更好的临床效益。 结论 基于血清sST2、NT-proBNP及超声心动图参数构建的列线图预测模型对AMI后HF患者发生心肌重塑的预测价值较高。

Objective To study the association between serum soluble growth stimulating expression factor 2 （sST2）， N?terminal pro?B?type natriuretic peptide （NT?probNP）， and echocardiographic parameters with myocardial remodeling in patients with heart failure （HF） after acute myocardial infarction （AMI）. Methods A total of 120 patients with HF after AMI admitted to the hospital from January 2023 to January 2024 were enrolled. According to the results of echocardiography during a 6?month follow?up， the enrolled patients were divided into a myocardial remodeling group and a non?myocardial remodeling group. Serum sST2， NT?proBNP and echocardiographic parameters were compared between groups， and the predictive value on myocardial remodeling was analyzed. Results According to the Killip heart failure classification， the patients were classified into three groups. The sST2， NT?proBNP， left ventricular end?diastolic diameter （LVEDD）， left ventricular end?systolic diameter （LVESD） and left atrial diameter （LAD） showed progressive increase in the three groups， Killip Ⅱ to Killip Ⅳ （P < 0.05）. Conversely， left ventricular ejection fraction （LVEF） decreased across the three groups （P < 0.05）. Multivariate analysis found that high sST2， high NT?proBNP and high LAD were independent risk factors of myocardial remodeling in patients with HF after AMI （P < 0.05）. ROC curve revealed that the area under the curve （AUC） of the nomogram model was 0.82 （95%CI： 0.71 ~ 0.92）. Hosmer?Lemeshow goodness of fit test of the model indicated that the chi?square value was 3.67 （χ² = 3.67， P = 0.801）， and it was considered that basic consistency was exhibited between the fitted probability value and actual probability value. After 1 000 times of Bootstrap repeated sampling， the calibration curve was drawn and found that the calibration curve had good consistency with the actual curve， and both were close to the ideal curve. Decision curve displayed that the net benefit of patients was higher than that of the other two extreme curves， and when the threshold probability was between 0.16 and 0.94， the model could produce better clinical benefits. Conclusion The nomogram prediction model based on serum sST2， NT-proBNP and echocardiographic parameters has high predictive value on myocardial remodeling in HF patients after AMI.