急性冠状动脉综合征患者血清ST2、MK、CPP的表达及临床意义

Expression and clinical significance of serum ST2,MK and CPP in patients with acute coronary syndrome

目的探讨人基质裂解素2(ST2)、中期因子(MK)、和肽素(CPP)在急性冠状动脉综合征(ACS)患者血清中的表达及临床意义。方法选取2018年5月至2019年5月于上海市第六人民医院住院治疗的110例冠状动脉粥样硬化性心脏病(冠心病)患者作为病例组,其中60例稳定性心绞痛(SAP)患者作为SAP组,50例ACS患者作为ACS组。选取同期经冠状动脉造影证实冠状动脉病变为阴性的60例非冠心病人群作为对照组。采用ELISA法检测病例组和对照组ST2、MK、CPP水平,比较各组差异。多因素logistic回归分析探讨ACS发病的影响因素。绘制受试者工作特征(ROC)曲线分析ST2、MK、CPP及联合检测对ACS的诊断价值。结果ACS组ST2、MK、CPP水平高于SAP组,SAP组高于对照组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示ST2、MK、CPP是ACS发病的独立影响因素(P<0.05)。Pearson相关性分析显示ST2、MK与CPP呈正相关,ST2、MK与肌钙蛋白-Ⅰ呈正相关(P<0.05)。ROC曲线分析结果显示ST2、MK、CPP及联合检测诊断ACS灵敏度分别为88.5%、73.1%、69.2%、92.8%。结论ST2、MK、CPP新型生物标志物对ACS早期诊断、危险分层方面可能具有重要作用。

Objective To investigate the expression and clinical significance of human stromal lysin 2(ST2),medium-term factor(MK),and peptide(CPP)in the serum of patients with the acute coronary syndrome(ACS).Methods A total of 110 patients with coronary atherosclerotic heart disease who were hospitalized in Shanghai Sixth People′s Hospital from May 2018 to May 2019 were selected as the case group,of which 60 cases of stable angina pectoris(SAP)were treated as the SAP group and 50 cases of ACS were treated as the ACS group.Sixty cases of non-coronary artery disease population with negative coronary artery lesions confirmed by coronary angiography were selected as the control group.The levels of ST2,MK,and CPP in the case and control groups were measured by ELISA,and the differences in levels between the groups were compared.Multi-factor logistic regression analysis was performed to explore the factors influencing the development of ACS.Receiver operating characteristic(ROC)curves were plotted to analyze the diagnostic value of ST2,MK,CPP and combined tests for ACS.Results The levels of ST2,MK and CPP were higher in the ACS group than in the SAP group,and higher in the SAP group than in the control group,with statistically significant differences(P<0.05).Multi-factor logistic regression analysis showed that ST2,MK and CPP were independent influences on the development of ACS(P<0.05).Pearson correlation analysis showed a positive correlation between ST2,MK and CPP,and a positive correlation between ST2 and MK and cTn-Ⅰ(P<0.05).ROC curve analysis showed that the sensitivity of ST2,MK,CPP and combined tests for the diagnosis of ACS were 88.5%,73.1%,69.2%and 92.8%,respectively.Conclusion The novel biomarkers of ST2,MK and CPP may have an important role in the early diagnosis and risk stratification of ACS.