摘要
目的探讨血清脂肪因子内脏脂肪组织源性丝氨酸蛋白酶抑制剂(vaspin)、脂肪素(apelin)对急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后发生主要不良心血管事件(MACE)的预测价值。方法选取2017年1月至2019年11月于济宁医学院附属医院行PCI的228例ACS患者为研究对象,根据患者PCI后1年内是否发生MACE分为MACE组(n=63)和非MACE组(n=165)。比较两组一般资料;酶联免疫吸附法(ELISA)测定血清vaspin、apelin水平;利用受试者工作特征(ROC)曲线评估血清vaspin、apelin水平预测ACS患者PCI后发生MACE的价值;Logistic回归分析ACS患者PCI后发生MACE的影响因素。结果MACE组ACS患者血清vaspin、apelin及左心室射血分数(LVEF)水平明显低于非MACE组(P<0.05),NYHA分级中Ⅱ~Ⅲ级比例明显高于非MACE组(P<0.05);血清vaspin、apelin预测ACS患者PCI后发生MACE的曲线下面积(AUC)分别为0.878、0.857,截断值分别为0.57 ng/ml、42.68 ng/L,相应敏感度分别为88.9%、87.3%,特异性分别为80.0%、78.2%,两者联合预测ACS患者PCI后发生MACE的AUC为0.943,其敏感度、特异性分别为85.7%、91.5%;NYHA分级是ACS患者PCI后发生MACE的危险因素(P<0.05),LVEF、vaspin、apelin是ACS患者PCI后发生MACE的保护因素(P<0.05)。结论PCI后发生MACE的ACS患者血清vaspin、apelin水平较低,vaspin、apelin联合检测可提高对ACS患者PCI后发生MACE的预测价值,有助于临床判断ACS患者PCI后是否发生MACE。
Objective To investigate the predictive value of serum adipokines-visceral adipose-specific serine protease inhibitor(vaspin)and aplinpeptides(apelin)to major adverse cardiovascular events(MACE)in patient with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods ACS patients undergone PCI(n=228)were chosen from Affiliated Hospital of Jining Medical University from Jan.2017 to Nov.2019.All patients were divided,according to MACE incidence within 1 y after PCI,into MACE group(n=63)and non-MACE group(n=165).The general materials were compared in 2 groups,and levels of vaspin and apelin were detected by using ELISA.The predictive value of vaspin and apelin levels to MACE incidence in ACS patients after PCI was reviewed by using ROC curve analysis.The influence factors of MACE incidence in ACS patients after PCI were analyzed by using Logistic regression analysis.Results The levels of vaspin,apelin and LVEF were significantly lower(P<0.05),and percentage of classes Ⅱ and Ⅲ of NYHA were significantly higher in MACE group than those in non-MACE group(P<0.05).The results of ROC curve analysis showed that AUC of vaspin for predicting MACE was 0.878,cutoff value was 0.57 ng/mL,sensitivity was 88.9%and specificity was 80.0%,and AUC of apelin was 0.857,cutoff value was 42.68 ng/L,sensitivity was 7.3%and specificity was 78.2%.The AUC of vaspin combined with apelin for predicting MACE was 0.943,sensitivity was 85.7%and specificity was 91.5%.The classification of NYHA was a risk factor of MACE(P<0.05),and LVEF,vaspin and apelin were protective factors of MACE(P<0.05).Conclusion The levels of vaspin and apelin are lower in ACS patients with MACE after PCI,and the detection of vaspin combined with apelin can improve the predictive value to MACE incidence,which is conducive for estimating MACE incidence in ACS patients after PCI in clinical practice.
作者
高荣华
陈雪英
张韶辉
戴雯
Gao Ronghua;Chen Xueying;Zhang Shaohui;Dai Wen(Third Department of Cardiology,Affiliated Hospital of Jining Medical University,Jining 272000,China;不详)
出处
《中国循证心血管医学杂志》
2021年第8期1003-1006,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
