摘要
目的分析血浆泛连接蛋白1(Pannexin-1,Panx-1)水平与ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后无复流现象的相关性。方法前瞻性分析2019年1月至2021年12月在广州中医药大学附属中山中医院接受急诊PCI的STEMI患者218例,根据PCI后心肌梗死溶栓试验分级分为正常复流组110例、慢复流组69例和无复流组39例。酶联免疫吸附测定血浆Panx-1水平,流式细胞术检测P选择素、血小板膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)及血小板-白细胞聚集体水平。结果无复流组年龄、糖尿病、发病至PCI时间、血小板计数、低密度脂蛋白胆固醇(LDL-C)、D-二聚体、P选择素、GPⅡb/Ⅲa、血小板-中性粒细胞聚集体(PNA)、血小板-单核细胞聚集体(PMA)、血小板-淋巴细胞聚集体(PLyA)、血浆Panx-1水平显著高于正常复流组和慢复流组(P<0.05)。STEMI患者血浆Panx-1水平与P选择素、GPⅡb/Ⅲa、PNA、PMA、PLyA呈正相关(P<0.05,P<0.01)。LDL-C≥3.20 mmol/L、血浆Panx-1>0.88 mg/L为STEMI患者PCI后无复流的独立危险因素(OR=2.198,95%CI:1.252~3.858,P=0.006;OR=16.849,95%CI:4.481~63.357,P=0.000)。血浆Panx-1预测STEMI患者PCI后无复流的曲线下面积为0.826(95%CI:0.744~0.907,P<0.01)。结论血浆Panx-1水平升高与STEMI患者PCI后无复流的发生密切相关,可作为预测PCI后无复流的生物标志物。
Objective To analyze the correlation between plasma Pannexin-1(Panx-1)level and no-reflow after percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STEMI).Methods A prospective trial was performed on 218 STEMI patients who underwent PCI in our hospital from January 2019 to December 2021.According to the blood flow classification of myocardial infarction thrombolysis(TIMI)after PCI,they were divided into normal reflow group(110 cases),slow reflow group(69 cases)and no reflow group(39 cases).The plasma Panx-1 level was determined by ELISA,and the levels of P-selectin,activated glycoproteinⅡb/Ⅲa(aGPⅡb/Ⅲa)and platelet-leukocyte aggregates(PLA)were determined by flow cytometry.Results Older age,larger ratio of diabetes mellitus,longer time from symptom onset to PCI,higher platelet count and levels of LDL-C,D-dimer,P-selectin,GPⅡb/Ⅲa,PNA,PMA,PLyA and plasma Panx-1 were observed in the no-reflow group than the normal and slow reflow groups(P<0.05).The plasma Panx-1 level in STEMI patients was positively correlated with P-selectin,GPⅡb/Ⅲa,PNA,PMA and PLyA(P<0.05,P<0.01).LDL-C≥3.20 mmol/L and plasma Panx-1>0.88μg/mL were independent risk factors for no-reflow after PCI in STEMI patients(OR=2.198,95%CI:1.252-3.858,P=0.006;OR=16.849,95%CI:4.481-63.357,P=0.000).The AUC value of Panx-1 was 0.826(95%CI:0.744-0.907,P<0.01)in predicting no reflux in STEMI patients after PCI.Conclusion The increase of plasma Panx-1 level is closely associated with the occurrence of no reflow in STEMI patients after PCI,and the protein can be used as a predictive biomarker for the phenomenon.
作者
黄国强
胡孜阳
赵永
李雪山
Huang Guoqiang;Hu Ziyang;Zhao Yong;Li Xueshan(Department of Cardiovascular Medicine,Zhongshan Hospital of Traditional Chinese Medicine,Guangzhou University of Traditional Chinese Medicine,Zhongshan 528400,Guangdong Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2024年第2期142-146,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
中山市社会公益科技研究项目(2018SYF04)。
关键词
心肌梗死
数据相关性
经皮冠状动脉介入治疗
前瞻性研究
预测
泛连接蛋白1
myocardial infarction
correlation of data
percutaneous coronary intervention
prospective studies
forecasting
Pannexin-1
