急性冠脉综合征患者血清M2BP、LTB4水平与冠状动脉病变程度的相关性分析

Analysis on correlation between serum M2BP,LTB4 levels and the degree of coronary artery disease in patients with acute coronary syndrome

目的检测急性冠脉综合征(ACS)患者血清中Mac-2结合蛋白(M2BP)、白三烯B4(LTB4)水平与冠状动脉病变程度的相关性,并探讨影响ACS发生的危险因素。方法回顾性选取2017年2月至2020年3月因心绞痛、心肌梗死及不明原因胸闷、胸痛在海南省人民医院初次进行冠状动脉造影的患者292例为研究对象。根据冠脉造影、病史、心电图等将患者分为稳定性冠心病组(SCAD组,n=45)、ACS组(n=142)和冠状动脉正常组(n=60),并根据Gensini评分将ACS患者分为轻度狭窄组(n=55)、中度狭窄组(n=45)和重度狭窄组(n=42)。酶联免疫吸附试验(ELISA)法检测受试者血清中M2BP、LTB4的水平。Pearson法分析ACS患者血清M2BP、LTB4水平与Gensini评分的相关性。二元Logistic回归分析影响ACS发生的危险因素。受试者工作特征曲线(ROC)分析M2BP、LTB4水平对ACS的诊断价值。结果受试者血清中M2BP、LTB4及Gensini评分比较差异均有统计学意义(P<0.05)。与对照组血清M2BP、LTB4水平[(3.52±0.88)μg/mL、(80.35±19.16)pg/mL]相比,SCAD组[(5.73±1.15)μg/mL、(126.82±55.83)pg/mL]、轻度狭窄组[(7.94±1.68)μg/mL、(251.32±66.58)pg/mL]、中度狭窄组[(10.22±1.93)μg/mL、(287.54±74.65)pg/mL]及重度狭窄组[(13.93±2.51)μg/mL、(316.32±82.74)pg/mL]血清M2BP、LTB4水平升高,差异均有统计学意义(P<0.05);SCAD组、轻度狭窄组、中度狭窄组、重度狭窄组血清M2BP、LTB4水平及Gensini评分比较差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,ACS患者血清中M2BP、LTB4水平与Gensini评分均呈正相关(r=0.596,0.518,P<0.05)。二元Logistic回归分析结果显示,血清中M2BP、LTB4水平偏高是ACS的独立危险因素(P<0.05)。血清M2BP、LTB4预测ACS的曲线下面积(AUC)分别为0.875(95%CI:0.808~0.942)、0.897(95%CI:0.841~0.954),联合检测预测ACS的AUC为0.961(95%CI:0.929~0.994)。结论ACS患者血清中M2BP、LTB4水平升高,与ACS发生有关,具有一定的预测价值,可能作为临床诊断ACS的潜在血清学指标。

Objective To detect the correlations between the levels of Mac-2 binding protein(M2BP),leukotriene B4(LTB4)and the degree of coronary artery disease in patients with acute coronary syndrome(ACS),and to explore the risk factors of acute coronary syndrome.Methods 292 patients who underwent coronary angiography at Hainan Provincial People's Hospital for the first time due to angina pectoris,myocardial infarction,unexplained chest tightness,and chest pain from February 2017 to March 2020 were selected as the study subjects.According to coronary angiography,medical history and electrocardiogram,the patients were divided into stable coronary heart disease group(SCAD group,n=45),ACS group(n=142)and normal coronary artery group(control group,n=60).According to Gensini score,ACS patients were divided into mild stenosis group(n=55),moderate stenosis group(n=45)and severe stenosis group(n=42).The serum levels of M2BP and LTB4 were detected by ELISA.Pearson method was used to analyze the correlation between serum M2BP and LTB4 levels and Gensini score in ACS patients.Binary logistic regression analysis affects the risk factors of ACS.The receiver operating characteristic curve(ROC)analyzed the diagnostic value of M2BP and LTB4 levels for ACS.Results The differences of M2BP,LTB4 and Gensini scores were statistically significant(P<0.05).Compared with the control group[(3.52±0.88)μg/mL,(80.35±19.16)pg/mL],the levels of serum M2BP and LTB4 in SCAD group[(5.73±1.15)μg/mL,(126.82±55.83)pg/mL],mild stenosis group[(7.94±1.68)μg/mL,(251.32±66.58)pg/mL],moderate stenosis group[(10.22±1.93)μg/mL,(287.54±74.65)pg/mL]and severe stenosis group[(13.93±2.51)μg/mL,(316.32±82.74)pg/mL]were increased,the differences were statistically significant(P<0.05);there were statistically significant differences in serum M2BP,LTB4 levels and Gensini score in SCAD group,mild stenosis group,moderate stenosis group and severe stenosis group(P<0.05).Pearson correlation analysis showed that the serum M2BP and LTB4 levels in ACS patients were positively correlated with Gensini score(r=0.596,0.518,P<0.05).Logistic regression analysis showed that high levels of M2BP and LTB4 were independent risk factors of ACS(P<0.05).Serum M2BP and LTB4 predicted the area under the curve(AUC)of ACS as 0.875(95%CI:0.808-0.942),0.897(95%CI:0.841-0.954),joint detection predicts AUC of ACS 0.961(95%CI:0.929-0.994).Conclusion The elevated levels of M2BP and LTB4 in ACS patients are related to the occurrence of ACS and have certain predictive value,which may be used as potential serological indicators for clinical diagnosis of ACS.