摘要
目的分析Adropin蛋白、肌钙蛋白和α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)评估冠状动脉性心脏病(coronary heart disease,CHD)经皮冠脉介入术(PCI)患者预后的临床价值。方法选取行PCI治疗的100例CHD患者为研究对象,根据预后情况分为预后良好组(n=75)和预后不良组(n=25),分别在术后7 d和术后6个月检测并比较2组患者的Adropin蛋白、肌钙蛋白和α-SMA水平。通过单因素分析和多因素logistic回归分析影响CHD介入治疗患者预后的相关因素和独立危险因素,并应用受试者工作特征曲线(ROC曲线)评价Adropin蛋白、肌钙蛋白和α-SMA在患者预后中的价值。结果术后7 d,预后良好组Adropin蛋白水平为(68.75±17.34)ng·L^(-1),预后不良组为(56.65±8.34)ng·L^(-1),预后良好组高于预后不良组,差异有统计学意义(P<0.05);术后6个月,预后良好组Adropin蛋白水平为(78.75±18.34)ng·L^(-1),预后不良组为(46.65±9.21)ng·L^(-1),预后良好组高于预后不良组,差异有统计学意义(P<0.05)。术后7 d和术后6个月,预后良好组α-SMA水平高于预后不良组,肌钙蛋白水平低于预后不良组,差异均有统计学意义(P<0.05)。通过单因素和多因素logistic回归分析显示,Adropin蛋白、肌钙蛋白和α-SMA是影响患者预后的独立危险因素(P<0.001),Adropin蛋白、肌钙蛋白和α-SMA联合指标评估患者预后的特异性(87.67%)、灵敏度(88.71%)、曲线下面积(area under curve,AUC)(0.876)均高于单一指标(P<0.05)。结论Adropin蛋白、肌钙蛋白和α-SMA水平均对CHD介入治疗患者预后具有较高的评估价值,其中三者联合的灵敏度、特异性及AUC均高于各独立指标,对CHD介入治疗患者临床诊断及预后评估具有重要价值。
Objective To analyze the clinical value of adropin,troponin andα-smooth muscle actin(α-SMA)in evaluating the prognosis of patients with coronary atherosclerotic heart disease(CHD)undergoing percutaneous coronary intervention(PCI).Methods 100 patients with coronary heart disease treated by PCI were divided into good prognosis group(75 cases)and bad prognosis group(25 cases).The levels of adropin,troponin andα-SMA in each group were measured on the 7th day and six months after the operation,and the levels of the two groups were compared.The single factor analysis and multiple factor logistic regression analysis were used to analyze the related factors and independent risk factors affecting the prognosis of patients with coronary heart disease(CHD)intervention.Receiver operating characteristics(ROC)was used to evaluate the prognostic value of adropin,troponin andα-SMA.Results On the 7th day after operation,the level of adropin protein in good prognosis group was(68.75±17.34)ng·L^(-1),and that in poor prognosis group was(56.65±8.34)ng·L^(-1),the difference was statistically significant(P<0.05).At six months after operation,the level of adropin protein in good prognosis group was(78.75±18.34)ng·L^(-1),and that in poor prognosis group was(46.65±9.21)ng·L^(-1),the difference was statistically significant(P<0.05).At 7 days and 6 months after operation,the level ofα-SMA in the good prognosis group was higher than that in the poor prognosis group,and the level of troponin was lower than that in the poor prognosis group,the difference was statistically significant(P<0.05).Univariate and multivariate logistic regression analysis showed that adropin protein,troponin andα-SMA were independent risk factors affecting the prognosis of patients(P<0.05).The specificity(87.67%),sensitivity(88.71%)and AUC(0.876)of combined indicators of adropin protein,troponin andα-SMA were higher than those of single indicator(P<0.05).Conclusion The levels of dropin,troponin andα-SMA are of high value in evaluating the prognosis of patients with coronary heart disease after interventional therapy,and the accuracy of the combined index of the three is significantly higher than that of the independent indexes,which is of great value in clinical diagnosis and prognosis evaluation of patients with coronary heart disease after interventional therapy.
作者
丁永丽
刘银芳
DING Yongli;LIU Yinfang(Department of Cardiovascular, Zhengzhou First People’s Hospital, Zhengzhou Henan 450000, China)
