血清S100B、S100A6、S100P水平升高与急性冠脉综合征的相关性研究

Association of increased S100B,S100A6 and S100P in serum levels with acute coronary syndrome

目的:探讨血清终末糖基化产物受体(RAGE)的配基S100B、S100A6、S100P水平与急性冠脉综合征(ACS)相关性。方法:连续收集882例冠状动脉造影患者,检测血清S100B、S100A6、S100P、游离RAGE(sRAGE)、肿瘤坏死因子(TNF)-α水平;根据临床表现及实验室资料,将患者分为对照组(n=251)、稳定型心绞痛(SA)组(n=211)及ACS组(n=420)。结果:ACS组血清S100B、S100A6、S100P和TNF-α水平[(103.73±56.90)ng/L、(5.28±4.15)μg/L、(8.73±7.96)μg/L、(87.82±39.30)ng/L]均显著高于SA组[(81.93±27.65)ng/L、(4.36±2.45)μg/L、(3.41±3.08)μg/L、(71.88±30.70)ng/L]和对照组[(78.00±22.71)ng/L、(3.97±2.57)μg/L、(3.38±2.74)μg/L、(57.07±27.23)ng/L,P<0.01];ACS组血清sRAGE水平高于对照组[(724.01±320.37)ng/L对(652.55±351.24)ng/L,P<0.01]。进一步将ACS组分为ST段抬高型心肌梗死(STEMI)和不稳定型心绞痛/非ST段抬高型心肌梗死(UA/NSTEMI)2个亚组进行分析,STEMI亚组的S100B、S100A6、S100P水平高于UA/NSTEMI亚组;ACS组血清S100B水平与肌钙蛋白I(cTnI)峰值水平相关(P<0.05),血清S100P水平与肌酸激酶同工酶(CK-MB)及cTnI峰值水平均有相关性(P<0.01)。多元回归分析发现,S100B、S100A6、S100P和传统危险因素均与ACS发病相关。结论:血清S100B、S100A6、S100P水平与ACS相关,与心肌缺血的损伤程度相关,它们在ACS的病理生理过程中发挥重要作用。

Objective：To investigate whether the serum levels of receptor for advanced glycation endproduct（RAGE）and ligands S100 B,S100A6and S100 P were related to acute coronary syndrome（ACS）. Methods：Serum levels of S100 B,S100A6,S100 P,soluble RAGE（sRAGE）,and TNF-!were analyzed in 882 consecutive patients.Based upon clinical and laboratory findings,the patients were categorized as control group（n=251）,stable angina（SA）group（n=211）,and ACS group（n=420）.Results：Serum S100 B,S100A6,S100 Pand TNF-αlevels[（103.73±56.90）ng/L,（5.28±4.15）μg/L,（8.73±7.96）μg/L,（87.82±39.30）ng/L]were higher in ACS group than in SA group [（81.93±27.65）ng/L,（4.36±2.45）μg/L,（3.41±3.08）μg/L,（71.88±30.70）ng/L]as well as in control group[（78.00±22.71）ng/L,（3.97±2.57）μg/L,（3.38±2.74）μg/L,（57.07±27.23）ng/L（each P〈0.01）],and sRAGE levels were higher in ACS patients versus controls[（724.01±320.37）ng/L vs（652.55±351.24）ng/L,with P〈0.01].These bio-measurements were further made by classifying ACS patients into ST-segment elevation myocardial infarction（STEMI）and unstable angina/non-ST-segment elevation myocardial infarction（UA/NSTEMI）subgroups,and STEMI patients had the higher S100 B,S100A6and S100 Plevels than UA/NSTEMI patients.In ACS group,S100 Blevel was correlated with troponin I（cTnI）level（P〈0.05）,while S100 Plevel was correlated with CK-MB and cTnI levels（P〈0.01）.In multivariable regression analysis,S100 B,S100A6,S100 Pand conventional risk factors were independently associated with ACS in patients. Conclusion：It indicates that serum levels of S100 B,S100A6and S100 Pare associated with ACS,and that serum levels of these proteins are related to the severity of myocardial infarction,implying that they are involved in the pathophysiology of ACS.