摘要
目的探究可溶性清道夫受体(sCD163)/可溶性肿瘤坏死因子样凋亡弱诱导因子(sTWEAK)预测急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后心肌损伤及主要不良心血管事件(MACE)的价值。方法选取2018年1月至2020年1月于河南科技大学第一附属医院心内科就诊的ACS患者172例为研究对象,依据患者术后发生心肌损伤情况分为心肌损伤组(64例)和心肌未损伤组(108例)。依据术后1年发生MACE情况分为非MACE组(122例)和MACE组(50例)。采用酶联免疫吸附法(ELISA)测定血清sCD163、sTWEAK水平,计算sCD163/sTWEAK比值;受试者工作特征(ROC)曲线评估sCD163/sTWEAK比值预测ACS患者PCI术后心肌损伤、发生MACE的价值;Logistic回归分析ACS患者PCI术后发生MACE的影响因素。结果心肌损伤组患者血清sCD163、sTWEAK水平及sCD163/sTWEAK比值均高于心肌未损伤组(P<0.05);MACE组患者sCD163、sTWEAK水平及sCD163/sTWEAK比值高于非MACE组(P<0.05);左心室射血分数(LVEF)、sCD163/sTWEAK比值是ACS患者发生MACE的影响因素(P<0.05);sCD163/sTWEAK比值预测ACS患者PCI术后心肌损伤、MACE的曲线下面积(AUC)分别为0.887、0.876;sCD163/sTWEAK比值高水平组患者MACE总发生率高于sCD163/sTWEAK比值低水平组(P<0.05)。结论sCD163/sTWEA比值在PCI术后发生心肌损伤的ACS患者中水平较高,且与不良预后相关,具有预测ACS患者PCI术后心肌损伤及预后的潜在价值。
Objective To investigate the predictive value of ratio of soluble cluster of differentiation 163 to soluble tumor necrosis factor-like weak inducer of apoptosis(sCD163/sTWEAK)to myocardial injury and major adverse cardiovascular events(MACE)in patients with acute coronary syndrome(ACS)after PCI percutaneous coronary intervention(PCI).Methods ACS patients(n=172)were chosen from Department of Cardiology in the First Affiliated Hospital of Henan University of Science and Technology from Jan.2018 to Jan.2020,and all patients were divided,according to postoperative occurrence of myocardial injury,into injury group(n=64)and non-injury group(n=108).According to the occurrence of MACE 1 year after PCI,the patients were divided into non-MACE group(n=122)and MACE group(n=50).The levels of sCD163 and sTWEAK were detected by using ELISA,and sCD163/sTWEAK was calculated.The predictive value of sCD163/sTWEAK to myocardial injury and MACE was reviewed by using receiver operating characteristic(ROC)curve in ACS patients after PCI.The influence factors of MACE were analyzed by using Logistic regression analysis in ACS patients after PCI.Results The levels of sCD163 and sTWEAK and sCD163/sTWEAK all were higher in injury group than those in non-injury group(P<0.05).The levels of sCD163 and sTWEAK and sCD163/sTWEAK all were higher in MACE group than those in non-MACE group(P<0.05).The influence factors of MACE included left ventricular ejection fraction(LVEF)and sCD163/sTWEAK in ACS patients(P<0.05).The area under ROC curve of sCD163/sTWEAK in predicting myocardial injury was 0.887,and that in predicting MACE was 0.876 in ACS patients after PCI.The total incidence rate of MACE was higher in patients with high-level sCD163/sTWEAK than that in patients with low-level sCD163/sTWEAK(P<0.05).Conclusion The ratio of sCD163/sTWEA is higher in ACS patients with myocardial injury after PCI,and is related to poor prognosis.It has the potential value in predicting myocardial injury and prognosis in ACS patients after PCI.
作者
王丹
刘威
来利红
李春燕
Wang Dan;Liu Wei;Lai Lihong;Li Chunyan(Department of Cardiology,First Affiliated Hospital of Henan University of Science and Technology,College of Clinical Medicine,Henan University of Science and Technology,Luoyang 471003,China;不详)
出处
《中国循证心血管医学杂志》
2022年第11期1352-1356,共5页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
河南省医学科技攻关计划联合共建项目(LHGJ20190555)。
关键词
可溶性清道夫受体
急性冠脉综合征
可溶性肿瘤坏死因子样凋亡弱诱导因子
心肌损伤
主要不良心血管事件
Soluble cluster of differentiation 163
Acute coronary syndrome
Soluble tumor necrosis factor-like weak inducer of apoptosis
Myocardial injury
Major adverse cardiovascular events
