血清ApoB/ApoA1、LTBP-2、VASP对不稳定型心绞痛进展至急性心肌梗死的预测效能

Predictive efficacy of serum ApoB/ApoA1,LTBP-2,and VASP on the progression of unstable angina to acute myocardial infarction

目的探讨血清载脂蛋白B(ApoB)/载脂蛋白A1(ApoA1)、潜在转化生长因子结合蛋白-2(LTBP-2)、血管扩张刺激磷蛋白(VASP)对不稳定型心绞痛(UA)进展至急性心肌梗死(AMI)的预测效能。方法选取2020年1月至2021年12月收治的80例UA患者,根据住院期间是否进展为AMI分为AMI组(26例)和UA组(54例)。比较2组临床资料、血清ApoB/ApoA1、LTBP-2、VASP水平,分析各血清指标与冠脉狭窄程度、心功能分级及UA进展至AMI风险的关系,评价其对UA进展至AMI的预测效能。结果2组UA病程、冠脉狭窄程度、心功能分级差异有统计学意义(P<0.05);AMI组血清ApoB/ApoA1、LTBP-2水平高于UA组,VASP水平低于UA组(P<0.05);血清ApoB/ApoA1、LTBP-2与冠脉狭窄程度、心功能分级呈正相关,VASP与冠脉狭窄程度、心功能分级呈负相关(P<0.05);校正UA病程、冠脉狭窄程度、心功能分级等其他因素前后,血清ApoB/ApoA1、LTBP-2、VASP均与UA进展至AMI风险独立相关(P<0.05);血清ApoB/ApoA1、LTBP-2、VASP联合预测UA进展至AMI的AUC为0.951(95%CI:0.878~0.987),大于各指标单独预测。结论血清ApoB/ApoA1、LTBP-2、VASP可作为UA进展至AMI的预测因子,联合预测价值较为可靠,为临床及早防治提供帮助。

Objective To investigate the predictive efficacy of serum apolipoprotein B(ApoB)/apolipoprotein A1(ApoA1),latent transforming growth factor binding protein-2(LTBP-2),and vasodilator stimulating phosphoprotein(VASP)on the progression of unstable angina(UA)to acute myocardial infarction(AMI).Methods Eighty patients with UA treated in our hospital from January 2020 to December 2021 were selected and allocated to AMI group(n=26)and UA group(n=54)according to the aggravation of AMI during hospitalization or not.The clinical data,serum ApoB/ApoA1,Latent transforming growth factor-beta-1 binding protein-2(LTBP-2),and VASP levels of the two groups were compared.The correlation between each serum index and the degree of coronary stenosis,cardiac function classification and the risk of UA progression to AMI was analyzed.Their predictive efficacy for UA progression to AMI was evaluated.Results There were significant differences in the duration of UA,degree of coronary stenosis and cardiac function classification between the two groups(P<0.05).Serum ApoB/ApoA1 and LTBP-2 levels in the AMI group were significantly higher than those in the UA group,and VASP level was significantly lower(P<0.05).Serum ApoB/ApoA1 and LTBP-2 were positively correlated with the degree of coronary stenosis and cardiac function classification,and serum VASP was negatively correlated with them(P<0.05).After adjusting the duration of UA,degree of coronary stenosis and cardiac function classification,serum ApoB/ApoA1,LTBP-2,and VASP were found to be independent risk factors for the progression from UA to AMI(P<0.05).The area under the curve(AUC)of the combination detection of serum ApoB/ApoA1,LTBP-2,and VASP in predicting the risk of UA progressed to AMI was 0.951(95%CI:0.878-0.987),which was significantly higher than that of a single detection.Conclusion Serum ApoB/ApoA1,LTBP-2,and VASP can be used as predictors of UA progression to AMI,and their combination detection provides a reliable predictive potential,which contributes to early prevention and treatment of UA and AMI.