正五聚蛋白-3对急性冠状动脉综合征患者预后及危险分层的价值研究

Prognostic value of serum PTX3 levels in acute coronary syndrome

目的 探讨血浆正五聚蛋白-3（PTX3）浓度对急性冠状动脉综合征（ACS）患者临床预后及危险分层的价值.方法 对入选的172例ACS患者入院后24h内测定PTX3浓度,并随访1年,以再发心血管事件（包括心脏性死亡、非致命性心肌梗死、非致命性心力衰竭及反复心绞痛发作住院）作为研究终点.结果 随访1年,发生心血管事件47例,其中心脏性死亡6例,非致命性心肌梗死9例,非致命性心力衰竭11例,反复心绞痛发作住院21例.心血管事件者PTX3浓度较无心血管事件者显著增高,分别为（9.72±3.65）ng/ml、（7.10±2.78）ng/ml（P＜0.01） 同样,PTX3浓度增高（＞中位数7.33ng/ml）者出现心血管事件明显增加,分别为35、12例（P＜0.01）,COX比例风险模型多因素逐步分析显示PTX3浓度增高是ACS患者再发心血管事件的独立危险因子（RR=4.582,CI95% 2.236~9.391,P＜0.01）.结论 PTX3浓度增高的ACS患者再发心血管事件风险显著增加,PTX3浓度增高可能是ACS患者预后的独立预测因子.

Objective To assess the prognostic value of serum pentraxin3 （PTX3） levels in acute coronary syndrome （ACS）. Methods Serum PTX3 levels were measured in 172 consecutive patients admitted to hospital for ACS within 24h of onset and all patients were followed-up for 12 months. Cardiac events used as study end-point were defined as cardiac death, subsequent nonfatal acute myocardial infarction （AMI）, nonfatal heart failure and recurrent angina. Results During the 12-month follow-up period, there were 47 cardiac events, including 6 cases of cardiac death, 9 cases of nonfatal AMI, 11 cases of nonfatal heart failure and 21 cases of recurrent angina. Serum PTX3 concentration in event-free patients was 7.10± 2.78ng/mL, that in patients with cardiac events was 9.72 ± 3.65ng/mL （P 〈0.01）. Meanwhile, the cardiac events were more prevalent in patients with PTX3〉 7.33ng/mL than those with PTX3〈7.33ng/mL （35 VS 12 , P〈 0.01 ）. Cox proportional-hazards model using multivariate analysis showed that increased serum PTX3 （〉7.33ng/mL） was an independent risk factor for cardiac events within 1 year （RR=4. 582; 95%C1, 2.239-9.391）. Conclusion Elevation of serum PTX3 is associated with an increased risk of cardiac events in patients of acute coronary syndromes.