急性冠脉综合征患者PCI术后血浆CLEC-2水平与预后的关系

Relationship between plasma CLEC-2 level and prognosis in patients with acute coronary syndrome after PCI

目的:探讨急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后血浆C型凝集素样受体2(CLEC-2)水平与预后的关系。方法:前瞻性选取2016年1月至2017年6月在首都医科大学附属北京潞河医院就诊的150例ACS患者作为研究对象。采用受试者工作特征(ROC)曲线分析CLEC-2评估ACS患者预后的最佳截断点。根据CLEC-2评价ACS患者预后的最佳截断点将患者分为高CLEC-2组(n=32)和低CLEC-2组(n=118)。采用酶联免疫吸附法检测ACS患者血浆中CLEC-2水平,并通过Cox回归分析其与ACS患者预后的关系。结果:血浆CLEC-2评价ACS患者预后的ROC曲线下面积(AUC)为0.885(95%CI:0.812~0.958),最大约登指数为0.643,最佳截断点为158.63 pg/mL,敏感度为71.87%,特异度为92.37%。两组在年龄、ACS家族史、CLEC-2水平及左室射血分数(LVEF)等方面的差异有统计学意义(P均<0.05)。高CLEC-2组主要不良血管事件(MACE)的发生率明显高于低CLEC-2组(71.88%对7.63%,P<0.001),平均生存时间明显低于低CLEC-2组[17.25(15.40~19.10)个月对23.34(22.91~23.77)个月,P<0.001]。Cox单因素及多因素分析结果显示慢性阻塞性肺疾病及CLEC-2水平与ACS患者MACE发生密切相关。结论:高CLEC-2是ACS患者PCI后发生MACE的独立危险因素。

Objective:To investigate the relationship between plasma C-type lectin-like receptor 2(CLEC-2)level and prognosis in patients with acute coronary syndrome(ACS)following percutaneous coronary intervention(PCI).Methods:A total of 150 patients with ACS who were admitted to Beijing Luhe Hospital affiliated to Capital Medical University from January 2016 to June 2017 were prospectively included.The receiver operating characteristic(ROC)curve was used to determine the best cutoff point for CLEC-2 to evaluate the prognosis in patients with ACS.The patients were divided into high CLEC-2 group(n=32)and low CLEC-2 group(n=118),according to the best cutoff point value of CLEC-2.The plasma CLEC-2 level was detected by enzyme-linked immunosorbent assay.Cox regression was used to analysis the relationship between CLEC-2 level and the prognosis of patients with ACS.Results:The area under ROC curve(AUC)was 0.885(95%CI 0.812-0.958).The Youden index was the largest(0.390)when CLEC-2 level was 158.63 pg/mL,and the sensitivity was 71.87%,and the specificity was 92.37%.There were significant differences in age,ACS family history,CLEC-2 level,and left ventricular ejection fraction(LVEF)between the two groups(all P<0.05).The incidence of major adverse cardiovascular events(MACE)in the high CLEC-2 group was higher than that in the low CLEC-2 group(71.88%vs.7.63%,P<0.001),and the survival time of the high CLEC-2 group was lower than that of the low CLEC-2 group(17.25(15.40,19.10)months vs.23.34(22.91,23.77)months,P<0.001).Cox univariate and multivariate analysis showed that chronic obstructive pulmonary disease and CLEC-2 levels were closely associated with MACE in patients with ACS.Conclusions:High CLEC-2 is an independent risk factor for MACE after PCI in patients with ACS.