醛固酮与组织纤溶酶原激活物抑制物-1水平对急性冠脉综合征患者冠脉病变及近期预后的预测价值

The predictive value of Aldosterone and PAI-1 to the severity of coronary artery lesions and recent prognosis in patients with Acute coronary syndrome

目的 分析急性冠脉综合征（ACS）患者血浆醛固酮、纤溶酶原激活物抑制物1（PAI-1）水平对冠状动脉病变严重程度及患者近期预后的影响,并探讨两者的相关性.方法 选择行冠脉造影检查的患者160例,分为对照组（非冠心病组）48例和ACS组112例.冠脉造影检查前于升主动脉根部采血标本,测定醛固酮、PAI-1水平,根据冠脉造影结果,分析其与冠脉病变严重程度的关系;按冠脉病变狭窄程度积分（Gensini 积分）将入选病例分为低、中、高分三组,观察Gensini积分高低与血浆醛固酮、PAI-1水平的关系,并分析醛固酮、PAI-1对ACS患者经皮腔冠脉内介入治疗（PCI）后近期预后的预测价值.结果 （1）ACS组患者血浆醛固酮、PAI-1水平明显高于对照组患者（均P〈0.05）.（2）随Gensini积分升高,患者血浆醛固酮、PAI-1水平亦明显升高,三组患者血浆醛固酮、PAI-1水平：高分组〉中等组〉低分组（均P〈0.05）.（3）ACS组患者血浆醛固酮与PAI-1呈显著性正相关（r=0.213,P〈0.05）.（4）多因素Logistic回归分析显示醛固酮、PAI-1是ACS患者PCI术后30 d内MACE发生的独立预测因子.结论 ACS患者血浆醛固酮、PAI-1水平与冠脉病变严重程度相关,醛固酮与PAI-1之间的相互影响,并对ACS患者PCI术后的近期预后有预测价值.

Objective To investigate the predictive value of serum aldosterone and Plasminogen activator inhibitor-1 （ PAI-1 ） levels to the severity of coronary artery lesions and the recent prognosis in acute coronary syndrome （ACS） patients underwent percutaneous coronary intervention（PCI）. Methods The study included 160 consecutive patients admitted. All the patients received coronary angiography and were divided into two groups：control group and ACS group. The patients＇ blood samples were abtained at the root of aortic artery to measure the serum aldosterone and PAI-1 levels. We analyzed their relationship with the severity of coronary artery lesions. The patients were also divided into three groups（ high-score group, moderate-score group,low-score group）according to Gensini accumulated points,we analyzed the difference of aldosterone and PAI-1 levels in three groups. The predictive values of aldosterone and PAI-1 to the recent pronosis of ACS patients underwent PCIwere assessed. Results （ 1 ）The patients＇ serum aldosteeone and PAI-1 levels in ACS group were significantly higher than control group（ all P 〈0. 05 ） ;（2）The aldosterone and PAI-1 levels in high-score group were higher than moderate-score group, and moderate-score group was higher than low-score group. （3）The serum aldosterone level in ACS patients was positively correlated with the PAI-1 level （ r = 0.213, all P 〈 0. 05 ）. （ 4 ） Multiple factor Logistic regression analysis indicated that aldosterone, PAI-1 levels were srtong independent predictors for the recent prognosis of ACS patients underwent PCI. Conclusion The aldosterone ,PAI-1 levels in ACS patients were correlated with the severity of coronary artery lesions. Both of them were strong predictors for the recent prognosis of ACS patients underwent PCI.