血清E选择素、GDF-15及脂蛋白a对冠心病患者PCI术后不良心血管事件的预测分析

Predictive value of serum E-selectin,growth differentiation factor-15 and lipoprotein-a to adverse cardiovascular events in patients with coronary heart disease after PCI

目的探讨血清E选择素、生长分化因子15(GDF-15)及脂蛋白a对冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入治疗(PCI)术后发生不良心血管事件的预测价值。方法选择2020年1月至2022年1月于南阳市中心医院心内科就诊的150例冠心病患者为研究对象,根据患者术后6个月随访不良心血管事件的发生情况进行分组,发生不良心血管事件患者为试验组(n=20),未发生不良心血管事件为对照组(n=130),单因素分析冠心病患者PCI术后发生不良心血管事件的危险因素,采用ROC曲线分析血清E选择素、GDF-15及脂蛋白a在PCI术后发生不良心血管事件的预测价值。结果单因素分析结果显示,两组患者性别、年龄、体质指数(BMI)、吸烟、糖尿病、高血压、低密度脂蛋白胆固醇(LDL-C)比较,差异无统计学意义(P>0.05)。两组血清E选择素、GDF-15及脂蛋白a比较,差异有统计学意义(P<0.05);多因素非条件Logistic分析显示,血清E选择素、GDF-15及脂蛋白a均是冠心病患者PCI术后发生不良心血管事件的独立危险因素。ROC曲线结果显示,血清E选择素预测冠心病患者PCI术后发生不良心血管事件曲线下面积(AUC)为0.913,灵敏度为82.70%,特异度为85.00%,截断值为39.13 ng/ml。血清GDF-15预测冠心病患者PCI术后发生不良心血管事件的AUC为0.938,灵敏度为86.90%,特异度为90.00%,截断值为63.11 ng/L;血清脂蛋白a预测冠心病患者PCI术后发生不良心血管事件的AUC为0.957,为93.50%,特异度为98.50%,截断值为407.38 mg/L。结论在冠心病PCI术后发生不良心血管事件中,血清E选择素、GDF-15及脂蛋白a表达异常,在不良心血管事件的发生中具有一定预测价值。

Objective To investigate the predictive value of serum E-selectin,growth differentiation factor-15(GDF-15)and lipoprotein-a to adverse cardiovascular events(ACVE)in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods 150 patients with coronary heart disease who were admitted to the Department of Cardiology,Nanyang Central Hospital from January 2020 to January 2022 were selected as the study objects.According to the occurrence of adverse cardiovascular events at the follow-up 6 months after surgery,the patients with adverse cardiovascular events were divided into experimental group(n=20)and,No adverse cardiovascular events occurred in the control group(n=130).Univariate analysis of risk factors for adverse cardiovascular events in patients with coronary heart disease after PCI was conducted,and ROC curve was used to analyze the predictive value of serum E-selectin,GPF-15 and lipoprotein a in adverse cardiovascular events after PCInts after PCI.Results The results of single-factor analysis showed that the differences in gender,age,body mass index(BMI),smoking,diabetes,hypertension and low-density lipoprotein-cholesterol(LDL-C)had no statistical significance between 2 groups(P>0.05).The comparison in serum E-selectin,GDF-15 and lipoprotein-a had significant difference between 2 groups(P<0.05).The results of multi-factor non-conditional Logistic analysis showed that serum E-selectin,GDF-15 and lipoprotein-a were independent risk factors of ACVE in CHD patients after PCI(P<0.05).The results of ROC curve analysis showed that AUC of serum E-selectin was 0.913,sensitivity was 82.70%,specificity was 85.00%and cutoff value was 39.13 ng/mL in predicting ACVE,AUC of serum GDF-15 was 0.938,sensitivity was 86.90%,specificity was 90.00%and cutoff value was 63.11 ng/L,and AUC of serum lipoprotein-a was 0.957,sensitivity was 93.50%,specificity was 98.50%and cutoff value was 407.38 mg/L(P<0.05).Conclusion The expressions of that serum E-selectin,GDF-15 and lipoprotein-a are abnormal in CHD patients after PCI,which has some predictive value to the occurrence.