摘要
目的探讨血清硫酸吲哚酚(IS)、簇集蛋白(Clusterin)与急性冠脉综合征(ACS)患者冠状动脉病变的关系及对短期预后的预测价值。方法选择2021年6月至2022年10月郑州大学第一附属医院收治的120例ACS患者为研究对象(ACS组),另选择同期本院80名体检健康的志愿者作为对照组。采用酶联免疫吸附法检测ACS组患者和对照组受试者的血清IS、Clusterin水平。根据冠状动脉病变支数将ACS患者分为单支病变组(n=43)、双支病变组(n=49)、多支病变组(n=28),另根据Gensini积分将ACS患者分为轻度病变组(n=37)、中度病变组(n=48)、重度病变组(n=35),并根据院内短期预后将ACS患者分为预后良好组(n=85)和预后不良组(n=35)。通过单因素及多因素logistic回归分析ACS患者短期预后不良的影响因素,采用受试者操作特征(ROC)曲线分析血清IS、Clusterin水平对ACS患者短期预后不良的预测价值。结果ACS组患者的血清IS、Clusterin水平显著高于对照组(P<0.05)。单支病变组、双支病变组、多支病变组患者的血清IS、Clusterin水平依次升高(P<0.05)。轻度病变组、中度病变组、重度病变组患者的血清IS、Clusterin水平依次升高(P<0.05)。120例ACS患者短期预后不良发生率为29.17%(35/120)。单因素分析显示,ACS类型、Gensini评分、KILLIP分级、冠状动脉病变支数、IS、Clusterin与ACS患者短期预后有关(P<0.05)。多因素logistic回归分析显示,Gensini评分升高、IS升高、Clusterin升高、KILLIP分级≥Ⅲ级、冠状动脉多支病变为ACS患者短期预后不良的独立危险因素(P<0.05)。血清IS水平预测ACS患者短期预后不良的ROC曲线下面积(AUC)为0.747(95%置信区间:0.529~0.946),灵敏度为71.43%,特异度为74.12%,准确度为73.33%,约登指数为0.455;血清Clusterin水平预测ACS患者短期预后不良的AUC为0.693(95%置信区间:0.439~0.951),灵敏度为68.57%,特异度为70.59%,准确度为7.00%,约登指数为0.392;血清IS�
Objective To investigate the relationship between serum indoxyl sulfate(IS),Clusterin and coronary artery lesions in patients with acute coronary syndrome(ACS)and its predictive value for short-term prognosis.Methods A total of 120 ACS patients who were admitted to the First Affiliated Hospital of Zhengzhou University from June 2021 to October 2022 were selected as the research subjects(ACS group),and another 80 healthy volunteers who underwent physical examinations in our hospital during the same period were selected as the control group.Serum IS and Clusterin levels of patients in the ACS group and control group were detected by enzyme-linked immunosorbent assay.ACS patients were divided into a single-vessel disease group(n=43),a double-vessel disease group(n=49)and a multi-vessel disease group(n=28)according to the number of coronary artery lesions,divided into a mild lesion group(n=37),moderate lesion group(n=48)and severe lesion group(n=35)according to the Gensini score,and divided into a good prognosis group(n=85)and a poor prognosis group(n=35)according to the short-term prognosis.The influencing factors for poor short-term prognosis in ACS patients were analyzed by univariate and multivariate logistic regression,and the predictive value of serum IS and Clusterin levels for poor short-term prognosis in ACS patients was evaluated by receiver operating characteristic(ROC)curve.Results The serum IS and Clusterin levels of patients in the ACS group were significantly higher than those in the control group(P<0.05).The serum IS and Clusterin levels of patients in the single-vessel disease group,double-vessel disease group and multi-vessel disease group increased in turn(P<0.05).The serum IS and Clusterin levels of patients in the mild lesion group,moderate lesion group and severe lesion group increased in turn(P<0.05).The incidence of poor short-term prognosis in 120 ACS patients was 29.17%(35/120).Univariate analysis showed that,ACS type,Gensini score,KILLIP grade,number of coronary artery lesions,IS,and Cluste
作者
刘光辉
杜优优
孔涛
LIU Guanghui;DU Youyou;KONG Tao(Department of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450012,Henan Province,China)
出处
《新乡医学院学报》
CAS
2024年第8期737-743,共7页
Journal of Xinxiang Medical University
基金
河南省2022年科技发展计划项目(编号:222102310128)。
