冠心病患者PCI术后血清IL-33、sST2、LP-PLA2水平及其与预后的关系

The Association of Serum IL-33,sST2 and LP-PLA2 Levels with Prognosis of Patients with Coronary Heart Disease After PCI

目的分析冠心病(CHD)患者经皮冠状动脉介入术(PCI)术后血清白介素-33(IL-33)、可溶性生长刺激表达基因蛋白2(sST2)、脂蛋白相关磷脂酶A2(LP-PLA2)水平及其与预后的关系。方法选取2017年1月至2020年1月我院收治的128例行PCI治疗的CHD患者为研究对象,作为观察组,根据冠状造影结果分为单支病变组(n=48)、双支病变组(n=55)及多支病变组(n=25),并选取同期入院后未行PCI术治疗的CHD患者60例作为对照组,并随访术后6个月不良心血管事件(MACE)发生情况,根据MACE分为MACE组(n=25)和非MACE(n=103),检测血清IL-33、sST2、LP-PLA2水平,采用ROC曲线分析其水平对预后的评估价值。结果观察组血清IL-33、sST2、LP-PLA2水平高于对照组(P<0.05);多支病变组血清IL-33、sST2、LP-PLA2水平高于单支病变组和双支病变组,双支病变组血清IL-33、sST2、LP-PLA2水平高于单支病变组(P<0.05);MACE组血清IL-33、sST2、LP-PLA2水平高于非MACE组(P<0.05);Logistic回归分析显示,血清IL-33、sST2、LP-PLA2水平是影响CHD患者PCI术后发生MACE的危险因素(P<0.05);ROC曲线分析显示,血清IL-33、sST2、LP-PLA2水平联合预测CHD预后的灵敏度及特异性均高于单独预测(P<0.05)。结论CHD患者PCI术后血清IL-33、sST2、LP-PLA2水平升高,可预测冠脉病变程度和预后,值得临床推广。

Objective To analyze the correlations of serum interleukin-33(IL-33),soluble growth stimulation expressed gene 2(sST2)and lipoprotein-associated phospholipase A2(LP-PLA2)levels with prognosis of patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods 128 patients with CHD who were treated with PCI in the hospital from January,2017 to January,2020(the observation group)were enrolled in this study.According to the coronary angiography results,all subjects were divided into the single-vessel disease group(n=48),double-vessel disease group(n=55)and multi-vessel disease group(n=25).Meanwhile,60 patients with CHD who were not treated with PCI after admission were selected as the control group.Patients in the observation group were followed up for 6 months after operation,and the occurrence of major adverse cardiovascular events(MACE)was recorded.According to the follow-up results,all patients were divided into the MACE group(n=25)and non-MACE group(n=103).Serum IL-33,sST2 and LP-PLA2 levels were detected in all subjects,and ROC curves were applied to analyze the prognostic values of these markers.Results Serum levels of IL-33,sST2 and LP-PLA2 were higher in the observation group than those in the control group(P<0.05),also higher in the multi-vessel disease group than in the single-vessel disease group and the double-vessel disease group,higher in the double-vessel disease group than in the single-vessel disease group(P<0.05),and higher in the MACE group than in the non-MACE group(P<0.05).Logistic regression analysis showed that serum IL-33,sST2 and LP-PLA2 levels were risk factors for MACE in patients with CHD after PCI(P<0.05).ROC curve analysis showed that the sensitivity and specificity of serum IL-33,sST2 and LP-PLA2 in combination were higher than those of each index for the prognosis of CHD(P<0.05).Conclusion Patients with CHD have elevated serum IL-33,sST2 and LP-PLA2 levels after PCI,which can be used to predict the severity and prognosis of CHD.