生长停滞特异性蛋白6与hs-CRP、cTnI对急性心肌梗死的诊断价值

Diagnostic value of detection of growth arrest specific protein 6,hs-CRP and cTnI with acute myocardial infarction

目的探讨生长停滞特异性蛋白6(GAS6)与超敏C反应蛋白(hs-CRP)、心肌肌钙蛋白(cTnI)对急性心肌梗死(AMI)的诊断价值。方法选择2020年1月—2021年2月医院收治的110例AMI患者、105例稳定心绞痛患者及60例体检中心健康志愿者为研究对象,分别设为AMI组、稳定心绞痛组和对照组。比较3组患者的基础资料,用Logistic回归分析法分析AMI发生的危险因素,并绘制受试者工作特征曲线(ROC)分析GAS6与hs-CRP、cTnI对AMI的诊断价值。结果AMI组低密度脂蛋白-胆固醇(LDL-C)、白细胞计数(WBC)、cTnI、BNP、GAS6、hs-CRP水平高于稳定心绞痛组和对照组,冠脉病变(Gensini)评分高于稳定心绞痛组(P<0.05);稳定心绞痛组WBC、cTnI、BNP、GAS6、hs-CRP水平高于对照组(P<0.05),而稳定心绞痛组与对照组LDL-C水平差异无统计学意义(P>0.05)。Logistic回归分析显示,Gensini评分[OR=2.119(1.186~3.785)]、cTnI[OR=2.264(1.267~4.043)]、BNP[OR=2.248(1.137~5.463)]、GAS6[OR=2.351(1.316~4.200)]、hs-CRP[OR=4.465(2.380~6.401)]均是导致AMI发生的独立危险因素。ROC曲线分析结果显示,GAS6、hs-CRP、cTnI诊断AMI最佳截断点分别为15.75μg/L、13.74 mg/L、1.29μg/L,ROC曲线下面积(AUC)分别为0.878(0.827~0.919)、0.863(0.810~0.906)、0.931(0.889~0.961),GAS6与cTnI、hs-CRP比较,差异均无统计学意义(P>0.05),hs-CRP与cTnI比较,差异有统计学意义(P<0.05)。结论GAS6在AMI患者中异常高表达,且是AMI发生的独立危险因素,与AMI患者病情发展密切相关,可作为AMI诊断的参考指标。

Objective To investigate the diagnostic value of growth arrest-specific 6(GAS6),high-sensitivity C-reactive protein(hs-CRP)and cardiac troponin(cTnI)in the patients with acute myocardial infarction(AMI).Methods From January 2020 to February 2021,110 patients with AMI,105 patients with stable angina pectoris and 60 healthy volunteers from the physical examination center were selected as the research objects,and the patients were set as the AMI group,the stable angina group and the control group,respectively.The basic data of the patients with three groups were compared.The risk factors of AMI were analyzed by Logistic regression analysis,and a receiver operating characteristic curve(ROC)was drawn to analyze the diagnostic value of GAS6,hs-CRP,and cTnI for AMI.Results The levels of LDL-C,WBC,cTnI,BNP,GAS6,and hs-CRP in the AMI group were higher than those in the stable angina group and the control group,and thecoronary artery disease(Gensini)score was higher than that in the stable angina group(P<0.05).The level of WBC,cTnI,BNP,GAS6 and hs-CRP in the stable angina group were higher than those in the control group(P<0.05),while there was no difference in the level of LDL-C between the stable angina group and the control group(P>0.05).Logistic regression analysis showed Gensini score[OR=2.119(1.186~3.785)],cTnI[OR=2.264(1.267~4.043)],BNP[OR=2.248(1.137~5.463)],GAS6[OR=2.351(1.316~4.200)],hs-CRP[OR=4.465(2.380~6.401)]were independent risk factors of AMI.ROC curve analysis results show the best cut-off points for the diagnosis of AMI by GAS6,hs-CRP,and cTnI were 15.75μg/L,13.74 mg/L,1.29μg/L,and the area under the ROC curve(AUC)were 0.878(0.827~0.919)),0.863(0.810~0.906),0.931(0.889~0.961),the difference between GAS6 and cTnI,hs-CRP was not statistically significant(P>0.05),and the difference between hs-CRP and cTnI was statistically significant(P<0.05).Conclusion:GAS6 was abnormally highly expressed in the AMI patients and was an independent risk factor for the occurrence of AMI.It was closely related to the development of the AMI patients,and it can be used as a reference indicator for the diagnosis of AMI.