ACS患者血清五聚素3水平变化及其与冠脉病变范围、近期预后的相关性研究

Serum level of Pentraxin 3 and its correlation with coronary artery lesions and short-term prognosis in patients with acute coronary syndromes

目的:了解急性期蛋白五聚素3(PTX3)在急性冠状动脉综合征(ACS)患者血清中的水平变化,以及PTX3与冠脉病变范围、近期预后的关系。方法:收集我院心内科住院的冠心病(CHD)患者126例,其中不稳定型心绞痛(UAP组)51例,急性心肌梗死(AMI组)50例,稳定型心绞痛(SAP组)25例,选择同期在我院体检中心健康体检者(NC组)25例作为对照组。采用ELISA检测各组入院时空腹血清PTX3水平,以及ACS患者(UAP组+AMI组)在入院规范治疗1周后的血清PTX3水平,比较不同冠脉病变支数组的血清PTX3水平,出院后3个月对ACS患者进行电话随访,了解患者的近期预后。结果:①UAP组、AMI组的血清PTX3水平明显高于SAP组、NC组(P<0.05);SAP组PTX3水平亦高于NC组(P<0.05);而UAP组与AMI组的血清PTX3水平无差异。②ACS患者经过1周规范治疗后,复查的血清PTX3水平较入院时显著降低(P<0.01);但仍高于NC组的正常水平(P<0.01)。③冠脉双支病变组和3支病变组的血清PTX3水平明显高于单支病变组(P<0.05);④血清PTX3、hs-CRP和TC影响ACS患者的近期预后(死亡或因心脏事件再住院)(P<0.05)。结论:ACS患者血清PTX3水平显著升高,随冠脉病变支数的增加,血清PTX3水平增高。血清PTX3水平增高提示ACS患者近期预后不良。

Objective：To explore serum level change of pentraxin 3（PTX3） in patients with acute coronary syn- drome （ACS）, and the relationship between PTX3 and the branch number of coronary artery stenosis and short- term prognosis. Method：The 126 patients with coronary artery disease including unstable angina pectoris （UAP,n=51）, acute myocardial infarction （AMI, n=50）, stable angina pectoris （SAP, n=25） and healthy people（NC, n=25） were enrolled in this study. Serum level of PTX3 was detected by ELISA at admission and after one week treatment in the ACS patients. Serum level of PTX3 was compared in ACS patients with different branch number of coronary artery stenosis. The short-term prognosis of patients with ACS were evaluated by phone follow-up after 3 months. Result： （1）Serum level of PTX3 in UAP group and AMI group were significantly higher than that in SAP group and NC group （P〈0.05）. The level in SAP group was also higher than that in NC group （P〈0.05）. There was no significant difference between UAP group and AMI group. （2）After one week standard treatment, the serum level of PTX3 in patients with ACS was significantly lower than that at admission （P〈0.01）, but still higher than normal level of healthy controls （P〈0.01）. （3）Serum level of PTX3 in two and three coronary lesions group was significantly higher than that in one coronary lesions group（P〈0.05）. @Short-term prognosis of patients with ACS was affected by PTX3, hs-CRP and TC（P〈0.05 ）. Conclusion： Serum level of PTX3 is signifi- cantly elevated in patients with ACS. With the increase in number of coronary lesion, serum level of PTX3 elevat- ed in patients with ACS. Increased serum PTX3 indicates poor short-term prognosis of patients with ACS.