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目的测量入院即刻急性ST段抬高型心肌梗死(STEMI)患者血浆中血栓调节蛋白(TM)水平；探讨其与院内发生主要不良心血管事件(MACE)之间的关系。方法选自2014年1月~2015年1月入院行直接经皮冠状动脉介入治疗(PCI)的STEMI患者96例，测量入院时TM和降钙素原(PCT)水平，并根据血浆TM中位数水平，分为M1组(<血浆TM中位数水平，n=47)和M2组(逸血浆TM中位数水平，n=49)。另选入院健康体检者30名为对照组。采用二分类Logistic回归分析影响STEMI患者MACE发生的危险因素。结果①STEMI组患者血浆TM和PCT水平均高于对照组，差异有统计学意义(<0.01)。②STEMI组血浆TM与PCT水平呈正相关性(r=0.74，<0.01)；与血清Hs-CRP水平亦呈正相关性(r=0.58，<0.01)；血浆PCT与血清Hs-CRP水平呈正相关性(r=0.61，<0.01)。③M1组和M2组比较，高水平的TM组Hs-CRP和PCT水平高、TIMI危险指数和MACE发生率较高，差异均有统计学意义(均<0.05)。④发生MACE组和未发生MACE组比较，MACE事件组患者入院时TM、PCT及Hs-CRP水平较高(均<0.05)；TIMI危险指数高差异有统计学意义(<0.05)。虞STEMI组患者院内发生MACE的影响因素：所有入选96例患者院内MACE共发生16例，包括心源性死亡3例、心源性休克2例、其他心血管事件11例。血浆TM、PCT、血清Hs-CRP及TIMI危险指数预测STEMI患者院内发生MACE事件的曲线下面积分别为0.85、0.74、0.82、0.76(均<0.05)，表明血浆TM、PCT、血清Hs-CRP及TIMI危险指数对STEMI患者院内发生MACE预测均具有一定的准确性。采用二分类Logistic回归分析影响STEMI患者院内发生MACE的危险因素，结果显示：TM对STEMI患者院内MACE发生有统计学意义(0.05)。结论 STEMI患者入院时血浆TM和PCT水平升高，且二者呈正相关性。血浆TM水平与STEMI患者直接PCI术后院内MACE发生相关，亦可作为STEMI患者短期MACE的有效预测因子。“,”Objective To observe the level of plasma thrombomodulin (TM) on admission and investigate whether TM is related to in-hospital MACE,and the predictive value on short-term prognosis in patients with STEMI undergoing primary percutaneous coronary intervention (PCI).Methods Select 96 patients with STEMI undergoing primary PCI in our hospital from January 2014 to January 2015.Divide into two subgroups according to median TM level. Another 30 normal persons were selected as control group.To detect the concentration of TM and procalcitonin(PCT) on admission, Binary Logistic regression analysis of the risk factors influencing STEMI patients in - hospital MACE. Results The levels of plasma TM and PCT in the patients with STEMI were higher significantly than control group ( <0.01).The TM level was positively cor elated with PCT and hypersensitive C-reaction protein (Hs-CRP) in STEMI patients ( <0.01).There was a positive cor elation between PCT and Hs-CRP in STEMI patients ( <0.01).Compared with the lower TM level group, the higher TM level group were more likely to have higher Hs-CRP and PCT levels and higher TIMI risk index and incidence of MACE(al <0.05) .Compared with the no MACE group,the patients in MACE group have higher TM, PCT, Hs-CRP levels;and have higher TIMI risk index. There were significant dif erences (al <0.05) .The influence factors of in-hospital MACE for patients with STEMI.Among 96 STEMI patients,that MACE incidents occur ed in 16 cases, including 3 died of cardiac death,2 cases of cardiac shock,11 cases of other cardiovascular events. The area under the ROC curve of plasma TM level, plasma PCT level,serum Hs-CRP level and TIMI risk index in predicting the MACE among STEMI undergoing primary PCI patients were 0.85, 0.74,0.82 and 0.76 (al <0.05). Analyzing the risks af ecting the in-hospital MACE of STEMI patients with binary logistic regression, TM was closely related to them ( <0.05)while PCT,Hs-CRP and TIMI risk index had nothing to do with them. Conclusion Compared with the control group ,the levels of plasma TM and PCT on admission in the patients with STEMI were higher.Plasma TM level on admission was related to the in-hospital MACE in patients with STEMI undergoing primary PCI, and could be a bet er indicators.