人类软骨糖蛋白-39预测冠心病近期预后的研究

HCgp-39 on short-term prognosis in coronary heart disease

目的探讨人类软骨糖蛋白-39(human cartilage glycoprotein-39,HCgp-39)在冠心病(coronary heart disease,CAD)中的表达规律以及对冠心病30 d内心血管事件(major adverse cardiac event,MACE)的预测价值。方法2012年1月—2013年1月汉族患者181例,结合冠状动脉造影(coronary angiography,CAG)检查结果,分为急性心肌梗死(acute myocardial infarction,AMI)组56例,不稳定型心绞痛(unstable angina pectoris,UAP)组45例,稳定型心绞痛(stable angina pectoris,SAP)组40例,对照组40例,测定各组患者血浆HCgp-39水平,以及随访各组患者30 d内的MACE。计数资料比较采用χ2检验,计量资料多组比较应用单因素方差分析,相关性检验用Spearman秩相关分析,多因素分析采用多元Logistic回归分析。P<0.05为差异有统计学意义。结果 AMI组、UAP组、SAP组、对照组之间HCgp-39水平分别为(119.41±18.46)、(116.00±21.77)、(109.48±12.09)、(107.32±16.35)ng/ml,AMI组和UAP组差异无统计学意义(P>0.05);SAP组和对照组差异无统计学意义(P>0.05);HCgp-39在AMI组、UAP组中明显升高,与SAP组和对照组比较差异有统计学意义(P<0.05)。将随访30 d的MACE作为因变量,以YKL-40、糖尿病、Gensini积分、性别、年龄、高血压病、高脂血症、吸烟、冠心病家族史作为自变量,用Logistic回归分析,发现YKL-40、糖尿病与30 d内MACE关系最密切(OR值分别为1.078、3.379)。结论血浆HCgp-39水平可能反映冠状动脉粥样硬化斑块的病变性质,在冠心病30 d内MACE的发生中有一定的预测作用。

Objective To observe the rules of expression of human cartilage glycoprotein - 39 （ HCgp - 39） in coronary ar- tery disease （CAD） and its significance in predicting major adverse cardiac event（MACE） in CAD within 30 days. Methods From January 2012 to January 2013, a total of 181 patients of Han nationality were divided into four groups based on their coronary anglographic findings： acute myocardial infarction （AMI） group （ n = 56 ）, unstable angina Pectoris （UAP） group （ n = 45 ） , stable angina Pectoris （SAP）group （n = 40） and control group （n = 40）. All groups were detected for the plasma level of HCgp -39 and followed up for MACE within 30 days.x2 test was used for count data, single factor analysis of vari- ance for measurement data of multiple groups, Spearman rank correlation analysis for correlation; multivariate logistic re- gression analysis for multiple factors. Results （ 1 ） In terms of HCgp - 39 levels, no significant difference was found be- tween AMI group [ （ 119.41 ~ 18.46） ng/ml ] and UAP group [ （ 116.00 ＋ 21.77 ） ng/ml ] （ P 〉 0.05 ）, as well as between SAP group [ （ 109.48 ~ 12.09） ng/ml ] andcontrol group [ （ 107.32 ~ 16.35 ） ng/ml ] （ P 〉 0.05 ）. Serum levels of HC gp- 39 significantly increased in AMI group and UAP group, which were significantly different from those in SAP group andcon- trol group （P 〈0.05）. （2）Taking MACE within 30days as the dependent variable, YKL -40, diabetes mellltus, Genslnl score, sex, age, hypertension, hyperlipldemla, smoking, family history of CAD as the independent variable,logistlc re- gression analysis was conducted, which revealed that YKL -40 and diabetes mellitus were the most important risk factors of MACE within 30 days（ OR = 1. 078,3. 379）. Conclusions HCgp - 39 levels may reflect the status of coronary artery arth- eresclerosis and have a predictive role to the occurrence of MACE within 30 days.