血清sST2、gal-3水平与AMI患者发生LVR的关系

Relationship among serum sST2,gal-3 levels and LVR in AMI patients

目的:研究血清可溶性生长刺激表达基因2蛋白(sST2)、半乳糖凝集素(gal)-3水平与AMI患者发生左室重构(LVR)的关系。方法:选择我院135例AMI患者为AMI组。另选择同期140例体检健康者为健康对照组。比较两组一般资料、血清sST2、gal-3水平。随访3个月,依据是否发生LVR,AMI组被分为LVR组(61例)与无LVR组(74例),观察比较两组血清sST2、gal-3水平,并分析AMI患者发生LVR的影响因素及血清sST2、gal-3水平对AMI患者发生LVR的诊断价值。结果:与健康对照组比较,AMI组高血压比例(47.86%比71.11%)、TC[(3.35±0.65)mmol/L比(5.42±1.13)mmol/L]、LDL-C水平[(2.11±0.62)mmol/L比(4.73±0.74)mmol/L]、LVEDd[(46.25±3.26)mm比(64.35±5.62)mm]、LVESd[(28.61±4.23)mm比(53.75±10.23)mm]、血清sST2[(13.56±1.36)ng/ml比(22.14±3.26)ng/ml]、gal-3[(10.52±1.12)μg/L比(13.65±2.23)μg/L]水平均显著升高,LVEF[(64.24±7.31)%比(31.26±4.22)%]显著降低(P均=0.001)。与无LVR组比较,LVR组血清sST2[(16.52±2.63)ng/ml比(23.65±4.21)ng/ml]、gal-3[(12.67±2.36)μg/L比(14.25±2.85)μg/L]水平均显著升高(P均=0.001)。多因素Logistic回归分析显示,LVEF降低、血清sST2、gal-3水平升高均为AMI患者发生LVR的独立危险因素(OR=1.067~2.113,P<0.05或<0.01)。ROC曲线显示,sST2、gal-3及二者联合检测预测LVR的敏感度分别为70.9%、72.7%、87.3%,特异性分别为96.4%、87.3%、89.1%,AUC分别为0.839、0.815、0.929,前两者最佳截断值分别为20.799ng/ml、11.905μg/L。结论:AMI患者及AMI发生LVR患者血清sST2、gal-3水平均显著升高,血清sST2、gal-3水平升高是LVR的独立危险因素,且对LVR具有显著的诊断价值。

Objective:To study relationship among serum levels of soluble growth-stimulated gene protein 2(sST2),galectin-3(gal)-3 and left ventricular remodeling(LVR)in AMI patients.Methods:A total of 135 AMI patients in our hospital were enrolled as AMI group.Another 140 healthy people undergoing physical examination in our hospital simultaneously were regarded as healthy control group.General data,serum sST2 and gal-3 levels were compared between two groups.According to presence of LVR during three-month follow-up,AMI group was divided into LVR group(n=61)and no LVR group(n=74),and serum sST2 and gal-3 levels were compared between two group.Influencing factors of LVR and diagnosis value of serum sST2 and gal-3 levels for LVR were analyzed in AMI patients.Results:Compared with healthy control group,there were significant rise in percentage of hypertension(47.86%vs.71.11%),levels of TC[(3.35±0.65)mmol/L vs.(5.42±1.13)mmol/L],LDL-C[(2.11±0.62)mmol/L vs.(4.73±0.74)mmol/L],LVEDd[(46.25±3.26)mm vs.(64.35±5.62)mm],LVESd[(28.61±4.23)mm vs.(53.75±10.23)mm]and serum levels of sST2[(13.56±1.36)ng/ml vs.(22.14±3.26)ng/ml]and gal-3[(10.52±1.12)μg/L vs.(13.65±2.23)μg/L],and significant reductions in LVEF[(64.24±7.31)%vs.(31.26±4.22)%]in AMI group(P=0.001 all).Compared with no LVR group,there were significant rise in serum levels of sST2[(16.52±2.63)ng/ml vs.(23.65±4.21)ng/ml]and gal-3[(12.67±2.36)μg/L vs.(14.25±2.85)μg/L]levels in LVR group(P=0.001 all).Multivariate Logistic regression analysis indicated that decreased LVEF and increased serum sST2 and gal-3 levels were independent risk factors for LVR in AMI patients(OR=1.067~2.113,P<0.05 or<0.01).ROC analysis indicated that sensitivities of sST2,gal-3 and dual-detection were 70.9%,72.7%and 87.3%respectively,specificities of them were 96.4%,87.3%and 89.1%respectively,AUCs of them were 0.839,0.815 and 0.929 respectively for predicting LVR,and optimal cutoff points of former two were 20.799ng/ml and 11.905μg/L respectively.Conclusion:Serum levels of sST2 and gal-3 significantly rise in AMI patients and those with LVR.Increased serum levels of sST2 and gal-3 are independent risk factors for LVR and possess significant diagnostic value for LVR.