ACS患者冠状动脉旁路移植术后血清sST2、H-FABP和hsTnT水平及意义

Serum sST2,H-FABP and hsTnT Levels in Patients with ACS After Coronary Artery Bypass Grafting and Their Clinical Significances

目的探讨冠状动脉旁路移植术后血清可溶性生长刺激表达基因2(sST2)、心脏型脂肪酸结合蛋白(H-FABP)和超敏肌钙蛋白(hsTnT)水平变化及与预后的关系。方法选取2015年2月至2018年2月我院收治的169例急性冠脉综合征(ACS)患者为研究对象。选取同期80例健康体检者为对照组。检测并比较两组受试者血清sST2、H-FABP及hsTnT水平。采用Logistic回归分析影响冠状动脉旁路移植术后ACS患者预后的相关因素。采用受试者工作特征曲线(ROC)分析sST2、H-FABP、hsTnT及联合检测诊断ACS患者不良预后的价值。结果ACS组患者血清sST2、H-FABP及hsTnT水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后,ACS组患者血清sST2、H-FABP和hsTnT水平明显降低(P<0.05)。单因素及多因素Logistic回归分析显示,高血压、手术时间、TC、TG、sST2、H-FABP及hsTnT与ACS患者不良预后密切相关。单指标检测时,hsTnT诊断ACS患者不良预后的AUC为0.820,高于sST2的0.815及H-FABP的0.742,三者联合检测诊断患者不良预后的AUC为0.940,明显高于单独指标检测(P<0.05)。结论血清sST2、H-FABP及hsTnT与ACS患者冠状动脉旁路移植术后不良预后密切相关,三者联合检测有助于诊断ACS患者不良预后。

Objective To investigate the changes of serum soluble growth stimulator gene 2(sST2),heart-type fatty acid binding protein(H-FABP)and hypersensitive troponin(hs TnT)levels after coronary artery bypass grafting(CABG)and their relationships with prognosis. Methods 169 patients with acute coronary syndrome(ACS)admitted to our hospital from February,2015 to February,2018 were selected as the study subjects.80 cases of health examination subjects in the same period were selected as the control group.The serum levels of sST2,H-FABP and hs TnT were measured and compared between the two groups.Logistic regression was used to analyze the related factors affecting the prognosis of patients with ACS after coronary artery bypass grafting.The operating characteristic curve(ROC)was used to analyze the value of sST2,H-FABP,hs TnT and combined detection in the diagnosis of poor prognosis of patients with ACS. Results Serum levels of sST2,H-FABP and hs TnT in ACS group were significantly higher than those in control group( P < 0.05).After the treatment,the serum levels of sST2,H-FABP and hs TnT in ACS group were significantly decreased( P < 0.05).Univariate and multivariate logistic regression analysis showed that hypertension,operation time,TC,TG,sST2,H-FABP and hs TnT were closely related to poor prognosis of patients with ACS.The AUC of poor prognosis of patients with ACS diagnosed by hsTnT was 0.820,higher than 0.815 for sST2 and 0.742 for H-FABP.The AUC of poor prognosis of patients diagnosed by combined detection of hs TnT was 0.940,which was significantly higher than that of single index detection( P <0.05). Conclusion Serum sST2,H-FABP and hs TnT are closely related to the poor prognosis of patients with ACS after coronary artery bypass grafting.The combined detection of the three factors can facilitate the diagnosis of the poor prognosis of patients with ACS.