血清血小板因子4、CXCL12水平与急性冠状动脉综合征患者预后的相关性分析

Correlation analysis of serum CXCL4 and CXCL12 levels with prognosis in patients with acute coronary syndrome

目的探讨血清血小板因子4(PF4)、C-X-C型趋化因子配体12(CXCL12)水平与急性冠状动脉综合征(ACS)患者预后的相关性。方法选取确诊为ACS的患者214例。测定患者入院24 h内血清PF4、CXCL12水平,出院后对患者进行6个月随访,依据是否发生主要不良心血管事件(MACE)将ACS患者分为MACE组(53例)、非MACE组(161例)。比较两组ACS患者PF4、CXCL12水平,一般资料及实验室指标空腹血糖、三酰甘油、高密度脂蛋白、低密度脂蛋白、超敏C反应蛋白(hs-CRP)差异;采用Pearson法分析PF4、CXCL12与实验室相关指标的相关性,采用logistic回归模型分析影响预后的因素,并采用ROC曲线分析血清PF4、CXCL12水平对ACS患者预后的诊断效能。结果与非MACE组比较,MACE组左室射血分数(LVEF)较低(P<0.05),血清hs-CRP、PF4、CXCL12水平较高(P<0.05)。Pearson相关分析显示,MACE组ACS患者PF4、CXCL12与LVEF均呈负相关(P<0.05);与hs-CRP均呈正相关(P<0.05)。二分类logistic回归分析结果表明,hs-CRP、PF4、CXCL12升高是ACS患者发生MACE的危险因素(P<0.05),LVEF下降是ACS患者预后保护因素。ROC曲线显示,血清PF4、CXCL12、LVEF、hs-CRP预测ACS患者发生MACE的曲线下面积分别为0.755、0.817、0.649、0.621,其中血清PF4、CXCL12预测ACS患者发生MACE的效能明显高于LVEF、hs-CRP(P<0.05)。结论血清PF4、CXCL12水平高是ACS患者发生MACE的危险因素,可为ACS患者预后预测提供依据。

Objective To investigate the correlation between the serum levels of platelet factor 4(PF4)and C-X-C motif chemokine ligand 12(CXCL12)and the prognosis of patients with acute coronary syndrome(ACS).Methods From May 2017 to November 2018,214 patients with ACS diagnosed in our hospital were selected.Serum CXCL4 and CXCL12 levels were measured within 24 hours after admission.Patients were followed up for 6 months after discharge.ACS patients were divided into MACE group(53 cases)and non-MACE group(161 cases)according to whether major adverse cardiovascular events(MACE)occurred.The levels of CXCL4 and CXCL12,general data and laboratory indexes,including fasting blood glucose,triacylglycerol,high-density lipoprotein,low-density lipoprotein and high-sensitivity C-reactive protein(hs-CRP),were compared between the two groups.Pearson method was used to analyze the correlation between PF4,CXCL12 and laboratory related indexes.Logistic regression model was used to analyze the factors affecting the prognosis,and ROC curve was used to analyze the diagnostic efficacy of serum PF4,CXCL12 levels on the prognosis of ACS patients.Results Compared with non-MACE group,the LVEF of MACE group was significantly lower(P<0.05);and the levels of hs-CRP,CXCL4 and CXCL12 were significantly higher(P<0.05).Pearson correlation analysis showed that CXCL4 and CXCL12 were significantly negatively correlated with LVEF and positively correlated with hs-CRP(P<0.05).The results of binary logistic regression analysis showed that hs-CRP,CXCL4 and CXCL12 were the risk factors of MACE in ACS patients,and LVEF was the prognostic protective factor(P<0.05).ROC curve showed that the area under the curve of serum PF4,CXCL12,LVEF and hs-CRP predicting MECE in ACS patients was 0.755,0.817,0.649 and 0.621,respectively;and the serum PF4 and CXCL12 were more effective than LVEF and hs-CRP in predicting MECE in ACS patients(P<0.05).Conclusion The high levels of serum CXCL4 and CXCL12 are the risk factors of MECE in ACS patients,which may provide the basis for prognosis prediction of ACS patients.