| 陈 静,尹德录,赵新华,李群星,赵国立.术前血清Lp-PLA2、sST2水平与急性冠状动脉综合征患者PCI术后冠状动脉慢血流/无复流的关系研究[J].,2023,(20):3989-3994 |
| 术前血清Lp-PLA2、sST2水平与急性冠状动脉综合征患者PCI术后冠状动脉慢血流/无复流的关系研究 |
| Study on the Relationship between Serum Lp-PLA2, sST2 Levels before Operation and Coronary Slow Flow/Non Reflow in Patients with Acute Coronary Syndrome after PCI |
| 投稿时间：2023-03-18 修订日期：2023-04-12 |
| DOI：10.13241/j.cnki.pmb.2023.20.038 |
| 中文关键词: 急性冠状动脉综合征 经皮冠脉介入术 Lp-PLA2 sST2 冠状动脉慢血流/无复流 |
| 英文关键词: Acute coronary syndrome Percutaneous coronary intervention Lp-PLA2 sST2 Coronary slow flow/non reflow |
| 基金项目:江苏省卫生健康委员会2020年度医学科研立项项目（重点B类）（ZDB2020029） |
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| 中文摘要: |
| 摘要 目的：探讨急性冠状动脉综合征（ACS）患者术前血清脂蛋白相关磷脂酶A2（Lp-PLA2）、可溶性生长刺激表达基因2蛋白（sST2）表达情况，分析术前血清Lp-PLA2、sST2与经皮冠脉介入术（PCI）术后冠状动脉慢血流/无复流（CSF/CNF）的关系。方法：选择2019年9月至2022年9月在徐州医科大学附属连云港医院心内科进行PCI治疗的ACS患者386例为ACS组，根据术后心肌梗死溶栓实验（TIMI）血流分级分为CSF/CNF组（138例）和正常血流组（248例）；另选择同期在本院体检的健康对象174例为健康对照组。采用酶联免疫吸附法（ELISA）检测ACS患者术前及健康志愿者体检时血清Lp-PLA2、sST2水平，比较ACS组与健康对照组血清Lp-PLA2、sST2水平。采用单因素及多因素logistic回归模型分析CSF/CNF的影响因素，采用受试者工作特征（ROC）曲线分析术前血清Lp-PLA2、sST2对ACS患者PCI术后CSF/CNF的预测价值。结果：术前血清Lp-PLA2、sST2水平ACS组高于健康对照组（P＜0.05）；单因素分析结果显示，CSF/CNF组术前血肌酐（Scr）、超敏C反应蛋白（hs-CRP）、D-二聚体（D-D）、Lp-PLA2、sST2水平均高于正常血流组（P＜0.05）；多因素logistic回归模型分析结果显示，术前血清Lp-PLA2、sST2水平升高是ACS患者PCI术后发生CSF/CNF的独立危险因素（P＜0.05）。ROC曲线分析结果显示，两指标联合预测ACS患者PCI术后CSF/CNF的曲线下面积（AUC）显著高于术前血清Lp-PLA2、sST2单独检测。结论：PCI术后发生CSF/CNF的ACS患者术前血清Lp-PLA2、sST2水平异常升高，术前检测血清Lp-PLA2、sST2能较准确预测CSF/CNF，两者联合检测的预测效能更高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the expression of lipoprotein associated phospholipase A2 (Lp-PLA2) and soluble growth stimulating gene 2 protein (sST2) before operation of patients with acute coronary syndrome (ACS), and to analyze the relationship between preoperative serum Lp-PLA2, sST2, and postoperative coronary slow flow/non reflow (CSF/CNF) after percutaneous coronary intervention (PCI). Methods: 386 ACS patients who underwent PCI treatment in Department of Cardiology, Lianyungang Hospital Affiliated to Xuzhou Medical University from September 2019 to September 2022 were selected as the ACS group. They were divided into CSF/CNF group (138 cases) and normal blood flow group (248 cases) based on postoperative myocardial infarction thrombolysis test (TIMI) blood flow grading. Another 174 healthy subjects who underwent physical examination in our hospital during the same period were selected as the healthy control group. Enzyme linked immunosorbent assay (ELISA) was used to detect the serum levels of Lp-PLA2 and sST2 before operation in ACS patients before surgery and in healthy volunteers during physical examinations. The serum levels of Lp-PLA2 and sST2 were compared between the ACS group and the healthy control group. The influencing factors of CSF/CNF were analyzed using univariate and multivariate logistic regression models. The predictive value of preoperative serum Lp-PLA2 and sST2 on postoperative CSF/CNF in ACS patients was analyzed by receiver operating characteristic (ROC) curves. Results: The levels of Lp-PLA2 and sST2 before operation in the ACS group were higher than those in the healthy control group (P<0.05). The results of univariate analysis showed that the preoperative levels of serum creatinine (Scr), hypersensitive C-reactive protein (hs-CRP), D-dimer (D-D), Lp-PLA2, and sST2 in the CSF/CNF group were higher than those in the normal blood flow group (P<0.05). The results of multivariate logistic regression model analysis showed that elevated preoperative serum Lp-PLA2 and sST2 levels were independent risk factors for postoperative CSF/CNF in ACS patients after PCI (P<0.05). The ROC curve analysis results showed that the area under the curve (AUC) of CSF/CNF predicted by the combination of the two indicators in ACS patients after PCI was significantly higher than that detected by preoperative serum Lp-PLA2 and sST2 alone. Conclusion: Patients with ACS who develop CSF/CNF after PCI have abnormally elevated levels of serum Lp-PLA2 and sST2 before surgery. Preoperative detection of serum Lp-PLA2 and sST2 can accurately predict CSF/CNF, and the combined detection of the two has a higher predictive efficacy. |
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