S100A8/A9与不稳定型心绞痛患者冠状动脉病变及短期预后相关性分析

Correlation of S100A8/A9level with the severity of coronary artery disease and short-term prognosis in patients with unstable angina pectoris

目的探讨不稳定型心绞痛患者经皮冠状动脉介入术(percutaneous coronary intervention,PCI)前血清S100A8/A9蛋白水平与冠状动脉病变严重程度的相关性以及PCI后S100A8/A9蛋白水平变化与短期预后的相关性。方法行冠状动脉造影检查的不稳定型心绞痛患者99例,其中冠状动脉正常27例(对照组),冠状动脉病变72例(冠状动脉病变组,均行PCI),再根据Gensini评分将冠状动脉病变组分为轻中度病变(Gensini评分1~59分)组43例和重度病变组(Gensini评分≥60分)29例。记录患者临床资料,采用ELISA法检测血清S100A8/A9蛋白水平,采用Spearman相关法分析S100A8/A9蛋白水平与Gensini评分的相关性,采用多因素logistic回归分析冠状动脉病变严重程度的危险因素,应用Cox比例风险回归模型分析患者PCI前、后S100A8/A9蛋白水平变化与短期预后的关系。结果冠状动脉病变组PCI前血清S100A8/A9蛋白水平[628.80(359.90,1045.00)μg/L]高于对照组[362.30(230.80,558.50)μg/L](P<0.05);重度病变组PCI前血清S100A8/A9蛋白水平[813.50(577.10,1645.00)μg/L]高于轻中度病变组[505.50(300.60,862.10)μg/L](P<0.05)。冠状动脉病变组PCI前血清S100A8/A9蛋白水平与冠状动脉Gensini评分呈正相关(r=0.332,P=0.004)。PCI术前血清S100A8/A9蛋白水平升高是冠状动脉重度病变的独立危险因素(OR=1.091,95%CI:1.010~1.178,P=0.027)。冠状动脉病变患者PCI后S100A8/A9蛋白水平较术前每升高100个单位,发生短期主要心血管不良事件的风险提高5.8%(HR=1.058,95%CI:1.021~1.096,P=0.002)。结论不稳定型心绞痛冠状动脉病变患者PCI前S100A8/A9蛋白水平与冠状动脉病变严重程度相关,PCI前、后S100A8/A9蛋白变化水平与患者短期预后相关。

Objective To investigate the correlations between serum S100A8/A9protein level and coronary artery disease severity before percutaneous coronary intervention(PCI)and between S100A8/A9protein level and short-term prognosis after PCI in patients with unstable angina pectoris.Methods Ninety-nine patients undergoing coronary angiography due to unstable angina pectoris were divided into 27patients with normal coronary arteries(control group)and 72patients with coronary artery disease(coronary artery disease group).And according to the Gensini score,the patients were also divided into 43patients with Gensini score 1to 59(mild and moderate group)and 29patients with Gensini score≥60(severe group).The clinical data of patients were recorded,and the serum S100A8/A9protein level was detected by ELISA technique.Spearman correlation analysis method was used to analyze the correlation between S100A8/A9protein levels and Gensini scores;multivariate logistic regression analysis was used to analyze the risk factors for severe coronary artery disease;Cox regression model was used to analyze the correlations of the changes of S100A8/A9before and after PCI with the short-term prognosis.Results The serum S100A8/A9protein levels was higher in coronary artery disease group(628.80(359.90,1045.00)μg/L)than that in control group(362.30(230.80,558.50)μg/L)before PCI(P<0.05),and higher in severe group(813.50(577.10,1645.00)μg/L)than that in mild and moderate group(505.50(300.60,862.10)μg/L)(P<0.05).The preoperative S100A8/A9protein level was positively correlated with Gensini score(r=0.332,P=0.004)in coronary artery disease group,and the elevated S100A8/A9protein level before operation was the independent risk factor for severe coronary artery disease(OR=1.091,95%CI:1.010-1.178,P=0.027).The risk for short-term major cardiovascular adverse events increased by 5.8%for every 100units of elevated S100A8/A9 after PCI(HR=1.058,95%CI:1.021-1.096,P=0.002).Conclusion The level of S100A8/A9protein before PCI is correlated with the severity of coronary artery disease.The change level of S100A8/A9protein before and after PCI is involved in the short-term prognosis of patients with unstable angina pectoris.