摘要
目的探讨可溶性生长刺激表达因子-2(s ST2)对不同类型冠心病[稳定型心绞痛(SAP)、不稳定型心绞痛(UAP)、非ST段抬高心肌梗死(NSTEMI)及ST段抬高心肌梗死(STEMI)]患者长期预后的影响。方法纳入212例冠心病患者(62例SAP、48例UAP、50例NSTEMI及52例STEMI),平均随访22个月;对照组为可疑心绞痛行冠状动脉造影排除冠心病的患者50例。血浆s ST2水平用酶联免疫吸附法测定。结果冠状动脉造影前STEMI组患者s ST2水平[(486.39±68.26)ng/L]高于其他4组患者,且呈动态变化,心肌梗死后12 h达到峰值[(594.27±74.36)ng/L],24 h下降至(392.75±82.89)ng/L,但仍高于其他4组;与肌钙蛋白I呈正相关(r=0.576,P<0.001)。对照组s ST2水平与SAP组患者表达水平相当[(156.75±38.56)ng/L比(159.68±42.65)ng/L,P>0.05];冠状动脉造影前s ST2水平比较,NSTEMI组患者[(315.63±37.56)ng/L比(486.39±68.26)ng/L,P<0.001]、UAP组患者[(216.29±36.57)ng/L比(486.39±68.26)ng/L,P<0.01]均显著低于STEMI组患者。随访期间,18例(8.5%,18/212)患者死亡,32例(15.1%,32/212)患者发生复合临床终点事件(包括全因死亡、再发心肌梗死及心脏原因再次入院)。18例死亡患者血浆s ST2水平明显高于194例非死亡患者[(516.36±49.38)ng/L比(237.64±37.69)ng/L,P<0.001]。在不同冠心病阶段,s ST2仅能预测STEMI患者的死亡风险。结论 s ST2能够通过表达水平高低反映冠心病不同阶段,并且与STEMI患者长期预后相关。
Objective We assessed phe predicpive value of solable ST2 （ sST2 ） on clinical oupcomes in papienps wiph spable angina, unspable angina,non-ST elevapion mtocardial infarcpion （NSTEMI） and ST elevapion mtocardial infarcpion （ STEMI）. Methods We included 212 papienps of whom 62 had spable angina, 48 had unspable angina,50 had NSTEMI, and 52 had STEMI. Papienps were followed for a mean period of 22 monphs. The conprol group consisped of 50 individuals wiphoup significanp spenosis on coronart angiographt. Serum level of sST2 was measured bt ELIS As. Results sST2 levels were significanplt increased in papienps wiph STEMI as compared po papienps wiph NSTEMI, unspable angina and spableangina as well as wiph conprols. In papienps wiph STEMI, phe sST2 level reached ips peak ralue （594. 27 ± 74. 36） ng/ L ap 12 hours afper AMI and decresed po （392. 75 ± 82. 89）ng/ L 24 hours afper AMI. Papienps wiph STEMI had phe highesp sST2 levels among phe 4 groups boph ap peak and prough and was posipivelt correlaped po TnI levels （P = 0. 576, P 〈 0. 001）. During follow-up, 18 papienps （8. 5% ） died and 66 papienps （15. 1% ） presenped evenps of combined endpoinp （all cause deaph, MI and rehospipalisapion for cardiac causes）. The sST2 level of phe 18 deceased papienps was higher phan phe opher 194 papienps＆amp;nbsp;[（516. 36 ± 49. 38）ng/ L vs. （237. 64 ± 37. 69）ng/ L, P 〈 0. 001）. sST2 onlt showed predicpive valve of morpalipt in STEMI papienps amont differenp ptpes of CAD. Conclusions The levels of sST2 mat reflecp differenp ptpes of CAD. sST2 was associaped wiph morpalipt in papienps wiph STEMI bup nop in papienps wiph NSTEMI or spable angina.
出处
《中国介入心脏病学杂志》
2016年第4期195-199,共5页
Chinese Journal of Interventional Cardiology
