血浆TSP-2水平与冠状动脉狭窄程度的关系

The relationship between plasma TSP-2 and coronary artery stenosis

目的探讨冠状动脉粥样硬化患者血浆TSP-2水平变化趋势,进一步研究血浆TSP-2水平与冠状动脉狭窄程度及相关炎症细胞因子的关系。方法选取2017年7-11月因胸痛、胸闷等症状入住扬州大学附属苏北人民医学心血管内科并接受冠状动脉造影术和/或经皮冠状动脉介入治疗及血液送检的患者106例。79例确诊为冠状动脉狭窄者作为实验组,27例冠状动脉造影正常者作为对照组。其中,实验组依据Gensini评分再次分为轻度狭窄组(GS≤12分)共27例,中度狭窄组(GS,12~60分)26例,重度狭窄组(GS≥60分)26例。采集患者入院基本临床指标并用酶联免疫法检测各组患者血浆TSP-2、hs-CRP、MMP-9水平。用统计学软件分析血浆TSP-2水平与冠状动脉狭窄程度即Gensini评分和炎症相关细胞因子hs-CRP、MMP-9的关系。结果血浆TSP-2在相邻两组组间均不存在差异(P>0.05),对照组与Gensini中评分组之间开始出现统计学差异(P<0.05)而对照组与Gensini高评分组之间具有显著统计学差异(P<0.01)。线性相关分析结果示血浆TSP-2水平与Gensini评分之间存在显著相关性(P<0.001,r=0.513 5)。血浆中TSP-2的水平与冠脉狭窄相关炎症细胞因子hs-CRP(P=0.035 7,r=0.204 2)、MMP-9(P=0.013 8,r=0.238 5)存在相关性。以TSP-2为因变量,Gensini评分、LVEF是血浆TSP-2水平的独立预测因子,均具有统计学差异(P<0.05);Logstic回归分析结果显示TSP-2、年龄、hs-CRP是冠状动脉狭窄病变的独立危险因素,HDL-C是独立保护因素,具有显著统计学差异(P<0.05)。ROC曲线提示,TSP-2和hs-CRP曲线下面积(AUC)分别为0.812、0.742和0.845均>0.5,P=0.00<0.01。结论血浆TSP-2水平与冠状动脉狭窄病变程度之间存在显著正相关性;血浆TSP-2水平与冠状动脉狭窄相关炎症细胞因子之间也存在着正相关性;血浆TSP-2水平在冠状动脉狭窄患者的术前冠状动脉情况评估中有着很好的应用价值;TSP-2是冠状动脉粥样硬化一个重要的干预、治疗和研究靶点。

Objective To measure the levels of plasma TSP-2 in patients with coronary atherosclerosis and its relationship with the degree of coronary artery stenosis and related plasma cytokines.Methods 79 patients with chest pain were divided into three groups based on Gensini score(Low group,Medium group and High group).27 normal patients were also included as normal control group.The levels of plasma TSP-2,hs-CRP,MMP-9 were detected by enzyme-linked immunoassay and the relationship between TSP-2 and coronary stenosis,namely Gensini score,hs-CRP,MMP-9 was analyzed.Results There was no difference in plasma TSP-2 between the Low,Medium and High groups(P>0.05).The control group and the Gensini medium score group began to show statistical differences(P<0.05)while the control group and the Gensini high score group were statistically significant(P<0.01).Linear correlation analysis showed that there was a significant correlation between plasma TSP-2 and Gensi-ni score(P<0.001,r=0.513 5).The level of plasma TSP-2 was correlated with cytokines hs-CRP(r=0.204 2,P=0.035 7),MMP-9(r=0.238 5,P=0.013 8).With TSP-2 as the dependent variable,Gensini score and LVEF are independent predictors of plasma TSP-2(P<0.05).Logistic regression analysis showed that TSP-2,age,and hs-CRP were independent risk factors for coronary artery stenosis,and HDL-C was an independent protective factor(P<0.01).The Receiver Operator Characteristic Curve(ROC)indicated that the areas under the TSP-2,and hs-CRP curves were 0.742,and 0.845,respectively,all greater than 0.5,P=0.00<0.01.Conclusion There is a significant positive correlation between plasma TSP-2 levels and the degree of coronary artery stenosis.There is al-so a positive correlation between plasma TSP-2 levels and plasma inflammatory cytokines.TSP-2 is an important in-tervention,treatment and research target for coronary atherosclerosis.