急性冠脉综合征患者血清SCD40L、Periostin、IMA、PAI-1水平改变以及心功能的研究

Changes of serum SCD40L,Periostin,IMA,PAI-1 levels and cardiac function in patients with acute coronary syndrome

目的探讨急性冠脉综合征患者血清可溶性白细胞分化抗原40配体(SCD40L)、骨膜蛋白(Periostin)、缺血修饰白蛋白(IMA)、纤溶酶原激活物抑制剂-1(PAI-1)水平以及心功能的改变。方法选择收治33例急性冠脉综合征患者作为观察组,31例稳定性心绞痛患者作为对照组。比较两组患者血清SCD40L、Periostin、IMA、PAI-1水平,左室射血分数(LVEF),舒张早期最大血流峰值/舒张晚期最大血流峰值(E/A),以及两组患者的5年累积生存率。结果观察组患者SCD40L(t=4.558,P<0.001)、Periostin(t=11.09,P<0.001)、PAI-1(t=2.119,P=0.038)水平明显高于对照组,LVEF(t=2.333,P=0.023)水平明显低于对照组,且差异有统计学意义(P<0.05);两组E/A值无显著差异(P>0.05);血清Periostin(r=-0.483,P=0.005)、PAI-1(r=-0.693,P<0.001)与LVEF呈显著负相关,差异有统计学意义(P<0.05);观察组患者5年累积生存率明显低于对照组,且差异有统计学意义(33.33%,11/33 vs.67.74%,21/31;Log-rankχ~2=4.146,P=0.029)。结论血清SCD40L、Periostin、IMA、PAI-1水平的变化对急性冠脉综合征患者的心功能状况有重要影响,控制好患者的血清SCD40L、Periostin、IMA、PAI-1水平,可以改善患者的身体健康,延长患者的寿命时间。

Objective To investigate the level of the acute coronary syndrome patients serum SCD40L, Periostin, IMA, PAI- 1 and heart function change. Methods In our hospital 33 cases of acute coronary syndrome patients were selected as the observation group, 31 cases of stable angina pectoris patients were selected as the control group. Comparison of two groups of patients with serum SCD40L, Periostin, IMA, PAI - 1 level, LVEF level, E/A value, and the two groups of patients with 5 year survival rate. Results sCD40L （ t = 4. 558, P 〈 0. 001 ） ,Periostin （ t = 11.09, P 〈0. 001 ） and PAI- 1 （ t = 2. 119, P = 0. 038 level in obse^wation group was significantly higher than that in the control group. LVEF （ t = 2. 333, P = 0. 023 ） level was significantly lower than that of control group, and the difference is statistically significant （ P 〈 0.05）. E/A was no significant difference. Serum periostin （ r = - 0. 483, P = 0. 005） , plasminogen activator inhibitor - 1 （ r = - 0. 693, P 〈 0. 001 ） and left ventricular ejection fraction （LVEF） showed a significant negative correlation, and the difference was statistically significant （ P 〈 0.05 ） ; patients in the observation group 5 year cumulative survival rate was significantly lower than that of the control group, and the difference was statistically significant （33.33% and 67.74% vs. 11/33, 21/31 ; log rank x^2 = 4. 146, P = 0. 029）. Conclusion Changes of serum sCD40L, Periostin, IMA, PAI- 1 levels in patients with acute coronary syndrome （ACS） cardiac function has important influence and control the patient＇s serum sCD40L, Periostin, IMA, PAI- 1 levels, can improve the health of patients and prolong the life time of the patients.