S100A8/A9对不稳定型心绞痛血运重建患者远期预后的影响

Effect of S100A8/A9 on Long-term Prognosis of Patients with Unstable Angina Pectoris after Revascularization

目的评估不稳定型心绞痛血运重建患者S100A8/A9表达水平,探讨其对患者远期预后的影响。方法连续入选2014年12月至2016年5月符合纳入标准的不稳定型心绞痛血运重建(PCI)患者66例,年龄为(65±9.5)岁。根据心脏有无增大分为心脏扩大组和心脏未扩大组左心室舒张末期内径(LVEDD)(男性>55 mm,女性>50 mm)《美国超声协会指南》,其中心脏扩大组36例,心脏未扩大组30例。收集患者临床指标、生化指标,所有患者均采用超声心动图和组织多普勒成像测定左室同步性、左室收缩和舒张功能,入院24小时内空腹静脉血检测血浆S100A8/A9。采用双变量线性相关分析LVEDD与S100A8/A9水平、生化指标、心脏结构及功能关系。结果心脏扩大组S100A8/A9表达水平为(2657.44±1211.85)ng·mL-1,大于心脏未扩大组(1633.10±807.27)ng·mL-1(P<0.05);S100A8/A9表达水平与LVEDD呈正相关(r=0.553,P<0.05);其次是空腹血糖与LVEDD呈正相关(r=0.439,P<0.05)、超敏C反应蛋白(hs-CRP)与LVEDD呈正相关(r=0.333,P<0.05)、LVEF与LVEDD呈负相关(r=-0.575,P<0.05);影响心室重构多因素Logistic回归分析得出S100A8/A9和LVEF的回归系数为0.002和-0.179(P均<0.05);S100A8/A9和LVEDD的ROC曲线显示ROC曲线下面积为0.868(P<0.01),灵敏度为86.1%,特异度为76.6%,准确率为75.8%。结论S100A8/A9表达水平与LVEDD存在正相关,S100A8/A9可能是影响心室重构的危险因素,可望成为预测心室重构的指标之一。

Objective To evaluate the expression of S100A8/A9 in patients with unstable angina pectoris,and to explore its effect on long-term prognosis of patients.Methods Total 66 patients(41 males and 25 females)with unstable angina pectoris who met the inclusion criteria were enrolled consecutively from December 2014 to May 2016.The average age was(65±9.5)years.According to whether the heart was enlarged or not on the basis of LVEDD(male>55 mm,female>50 mm)American Ultrasonic Association Guide,all patients was divided into three groups,there were 36 cases in cardiac enlargement group,30 cases in unenlarged heart group.The clinical and biochemical indexes were collected.Echocardiography and tissue Doppler imaging were used to measure left ventricular synchronism,left ventricular systolic and diastolic function.Fasting venous blood was used to detect plasma S100A8/A9 within 24 hours of admission.Bivariate linear correlation analysis was used to analyze the relationship between LVEDD and S100A8/A9,biochemical parameters,cardiac structure and function.Results The expression of S100A8/A9 in cardiac enlargement group was(2657.44±1211.85)ng·mL^-1,significantly higher than that in unenlarged heart group(1633.10±807.27)ng·mL^-1(P<0.05).The expression of S100A8/A9 was positively correlated with LVEDD(r=0.553,P<0.05),followed by a positive correlation between fasting blood glucose and LVEDD(r=0.439,P<0.05),and a positive correlation between hs-CRP and LVEDD(r=0.333,P<0.05).There was a negative correlation between LVEF and LVEDD(r=-0.575,P<0.05).Multivariate logistic regression analysis showed that the regression coefficients of fasting blood glucose and hs-CRP were 0.085 and 0.192(P>0.05),respectively,while the regression coefficients of S100A8/A9 and LVEF were 0.002 and-0.179(P all<0.05).The ROC curves of S100A8/A9 and LVEDD showed that the area under the ROC curve was 0.868(P<0.01),the sensitivity was 86.1%and the specificity was 76.6%.Conclusion There is a significant positive correlation between expression of S100A8/A9 and LVEDD.S100A8/A9 is a risk factor for ventricular remodeling,may be one of the predictors of ventricular remodeling.