血清FSTL-1在急性冠脉综合征的表达及临床意义

Expression and clinical significance of FSTL-1 in patients with acute coronary syndrome

目的观察急性冠脉综合征患者血清卵泡抑素样蛋白-1(FSTL-1)水平变化,探讨其临床价值。方法 90例确诊冠心病患者分为急性冠脉综合征组(ACS组,n=68)和稳定型心绞痛组(SAP组,n=22),依临床类型将急性冠脉综合征组再分为不稳定型心绞痛组(UAP组,n=23)、急性非ST段抬高型心肌梗死组(NSTEMI组,n=22)、急性ST段抬高型心肌梗死组(STEMI组,n=23);依冠状动脉病变范围分为单支组、双支组、多支组;25例冠脉造影检查正常者为对照组。于入院次日清晨空腹抽血,采用ELISA法测FSTL-1,免疫比浊法测C-反应蛋白(CRP)水平。结果急性冠脉综合征组FSTL-1、CRP明显高于对照组和SAP组(P<0.05);SAP组FSTL-1与对照组差异无统计学意义(P>0.05);ACS组三组间FSTL-1差异无统计学意义;单支组、双支组、多支组FSTL-1、CRP显著高于对照组(P<0.05),FSTL-1、CRP随冠脉病变支数增多而升高(P<0.05)。ACS组FSTL-1与CRP呈正相关(r=0.628,P<0.05)。结论急性冠脉综合征患者FSTL-1明显升高,FSTL-1可能与斑块稳定性及冠脉病变程度有一定关系。

Objective To explore the expression and clinical value of serum follistatin-like protein 1 （ FSTL-1 ） in patients with acute coronary syndrome（ACS）. Methods Ninty patients with coronary heart disease （CHD）were divided into acute coronary syndrome （ACS, n = 68 ）group and stable angina pectoris group（ SAP, n = 22）. ACS group was subdivided into unstable angina group（ UAP, n = 23）, non-ST-segment elevation myocardial infarction group （ NSTEMI, n = 22 ） and ST-segment elevation myocardial infarction group （STEMI,n =23）. All patients with CHD were divided into three groups according to the coronary artery lesion range：single vessel le- sion group, double vessels lesions group and multi vessels lesions group. Twenty-five controls with normal coronary arteries were chosen as control group. Serum level of FSTL-1 was detected by ELISA, and the CRP concentration was detected by immunoturbidimetry in the next morning after admission. Results The FSTL-1 and CRP levels in ACS group were significantly higher than those in control group and SAP group（ P 〈 0. 05 ）, but there was no significant difference in serum FSTL-1 between SAP group and control group （P 〉 0. 05）. There was no statistical difference in serum FSTL-1 level among the three subgroups of ACS. Serum FSTL-1 and CRP levels in single vessel lesion group, double vessels lesion group, multi vessels lesion group were significantly higher than that in control group（ P 〈 0.05） , and serum FSTL-1 and CRP levels were elevated with the increase of coronary artery lesion vessels （P 〈 0. 05 ）. In ACS group, serum FSTL-1 and hsCRP were positively correlated（r = 0.628 ,P 〈 0. 05）. Conclusion Serum FSTL-1 level significantly in- crease in patients with ACS,and it may be related to the plaque stability and the severity of coronary artery disease.