血清Angptl2/Angptl1比值与稳定型心绞痛患者急性心肌梗死发生风险的相关性分析

Correlation between serum Angptl2/Angptl1 ratio and risk of acute myocardial infarction in patients with stable angina pectoris

目的探究血清血管生成素样蛋白2/血管生成素样蛋白1(Angptl2/Angptl1)比值在稳定型心绞痛患者急性心肌梗死的表达情况及与疾病发生风险的关系。方法选取2018年2月至2019年3月于西安高新医院接受治疗的205例稳定型心绞痛患者,根据住院期间是否发生急性心肌梗死分为对照组(126例)与急性心肌梗死组(79例),收集患者临床资料,采用酶联免疫吸附法检测血清中Angptl2、Angptl1水平,计算Angptl2/Angptl1比值;Pearson相关性分析Angptl2/Angptl1与冠状动脉病变评分的关系;采用Logistic分析影响稳定型心绞痛患者发生急性心肌梗死的危险因素,受试者工作特征曲线(ROC)评估Angptl2、Angptl2/Angptl1在稳定型心绞痛患者发生急性心肌梗死中的诊断价值。结果急性心肌梗死组高血压患病例数、饮酒例数、血清Angptl2、Angptl2/Angptl1水平均显著高于对照组,高密度脂蛋白(HDL)水平、Gensini积分显著低于对照组(P均<0.05),两组Angptl1水平无明显变化(P>0.05)。血清Angptl2、Angptl2/Angptl1与Gensini积分呈负相关,(r=-0.457,r=-0.384,P均<0.05)。高血压、Gensini积分、Angptl2、Angptl2/Angptl1是影响稳定型心绞痛患者发生急性心肌梗死的危险因素。Angptl2预测的稳定型心绞痛患者急性心肌梗死的AUC值为0.836(95%CI:0.778~0.884),敏感性71.38%,特异性82.74%;Angptl2/Angptl1对稳定型心绞痛患者急性心肌梗死预测的AUC值为0.877(95%CI:0.821~0.916),敏感性79.51%,特异性88.74%。结论稳定型心绞痛患者发生急性心肌梗死后血清Angptl2水平、Angptl2/Angptl1比值升高,Angptl1水平无明显变化,Angptl2、Angptl2/Angptl1在稳定型心绞痛患者发生急性心肌梗死中均具有一定的预测价值,Angptl2/Angptl1预测价值更优。

Objective To investigate the expression of ratio of serum angiopoietin-like protein 2 and angiopoietin-like protein 1(Angptl2/Angptl1),and relationship between Angptl2/Angptl1 and risk of acute myocardial infarction(AMI)in patients with stable angina pectoris(SAP).Methods SAP patients(n=205)were chosen from High-tech Hospital,Xi’an City from Feb.2018 to Mar.2019,and divided,according to attack of AMI,into control group(n=126)and AMI group(n=79).The clinical data was collected from the patients.The levels of serum Angptl2 and Angptl1 were detected by using ELISA,and value of Angptl2/Angptl1 was calculated.The relationship between Angptl2/Angptl1 and scores of coronary artery lesions was analyzed by using Pearson correlation analysis.The risk factors influencing AMI were analyzed by using Logistic analysis,and diagnostic values of Angptl2 and Angptl2/Angptl1 were reviewed by using ROC curve in SAP patients.Results The cases of hypertension and drinking,level of serum Angptl2 and Angptl2/Angptl1 were significantly higher,and high-density lipoprotein(HDL)level and Gensini integrals were significantly lower in AMI group than those in control group(all P<0.05),while level of Angptl1 had no significantly changes in 2 groups(P>0.05).The level of serum Angptl2 and Angptl2/Angptl1 were negatively correlated to Gensini integrals(r=-0.457,r=-0.384,P均<0.05).Hypertension,Gensini integrals and level of serum Angptl2 and Angptl2/Angptl1 were risk factors of AMI in SAP patients.The value of AUC of Angptl2 was 0.836(95%CI:0.778~0.884),sensitivity was 71.38%and specificity was 82.74%in predicting AMI.The value of AUC of Angptl2/Angptl1 was 0.877(95%CI:0.821~0.916),sensitivity was 79.51%88.74%and specificity was in predicting AMI.Conclusion The level of serum Angptl2 and Angptl2/Angptl1 will increase and level of Angptl1 has no significant changes in SAP patients after AMI attack.The level of serum Angptl2 and Angptl2/Angptl1 has some predictive value and Angptl2/Angptl1 has higher predictive value to AMI attack.