急性ST段抬高型心肌梗死患者血清中sACE2、AngⅡ、Ang1-7表达水平及临床意义

Expressions and clinical significance of serum sACE2,AngⅡ,Ang(1-7)levels in STEMI patients

目的探讨可溶性血管紧张素转化酶2(sACE2)、血管紧张素Ⅱ(AngⅡ)、血管紧张素1-7(Ang1-7)水平以及AngⅡ/Ang1-7比值在急性ST段抬高型心肌梗死(STEMI)患者血清中的表达水平及临床意义。方法收集85例STEMI患者的临床资料和血液样本,并纳入50例非冠心病受试者作为非冠心病组。检测两组患者血清sACE2、AngⅡ、Ang1-7水平,并计算AngⅡ/Ang1-7比值。对STEMI患者进行冠状动脉(冠脉)造影,检查病变支数,根据Gensini评分判断冠脉病变严重程度。结果与非冠心病组受试者相比,STEMI组患者血清sACE2、AngⅡ、Ang1-7水平及AngⅡ/Ang1-7比值均升高(P<0.05)。与单支病变亚组相比,多支病变亚组患者血清AngⅡ、Ang1-7水平升高(P<0.05);而sACE2水平和AngⅡ/Ang1-7比值比较,差异无统计学意义(P>0.05)。随着冠脉病变程度加重,STEMI患者血清sACE2、AngⅡ、Ang1-7水平以及AngⅡ/Ang1-7比值均升高(P<0.05)。经多因素Logistic回归分析,AngⅡ(OR=1.354,95%CI:1.134~2.871)、AngⅡ/Ang1-7(OR=2.175,95%CI:1.375~3.967)比值是冠脉病变加重的独立影响因素(P<0.05)。结论STEMI患者血清sACE2、AngⅡ、Ang1-7水平及AngⅡ/Ang1-7比值均有不同程度地升高,可考虑AngⅡ/Ang1-7比值作为判断冠脉病变严重程度的辅助指标。

Objective To investigate the expression levels of soluble angiotensin converting enzyme 2(sACE2), angiotensin Ⅱ(AngⅡ), angiotensin 1-7(Ang1-7) and AngⅡ/Ang1-7 ratio in the serum of patients with acute ST-segment elevation myocardial infarction(STEMI) and their clinical significance. Methods Clinical data and blood samples of 85 patients with STEMI were collected, and 50 subjects with non-coronary heart disease were included as the non-coronary heart disease group. The serum levels of sACE2, AngⅡ and Ang1-7 were measured in both groups, and the ratio of AngⅡ/Ang1-7 was calculated. Coronary angiography was performed in STEMI patients, and the number of lesion branches was examined to determine the severity of coronary lesions according to Gensini score. Results Serum sACE2, AngⅡ, Ang1-7 levels and AngⅡ/Ang1-7 ratio were increased in STEMI group compared with non-CHD group(P<0.05). Compared with the single-vessel disease subgroup, the levels of serum AngⅡ and Ang1-7 were increased in the multivessel disease subgroup(P<0.05), while the levels of sACE2 and AngⅡ/Ang1-7 ratio were not significantly different(P>0.05). The levels of serum sACE2, AngⅡ, Ang1-7 and the ratio of AngⅡ/Ang1-7 were increased in STEMI patients with the severity of coronary artery lesions(P<0.05).By multivariate logistic regression analysis, AngⅡ(OR=1.354, 95%CI: 1.134~2.871), AngⅡ/Ang1-7(OR=2.175, 95%CI: 1.375~3.967) ratio were independent influencing factors of coronary lesion aggravation(P<0.05). Conclusion Serum levels of sACE2, AngⅡ, Ang1-7 and AngⅡ/Ang1-7 ratio were increased in STEMI patients to different degrees, and AngⅡ/Ang1-7 ratio could be considered as an auxiliary index to judge the severity of coronary artery lesions.