尿11-DH-TXB_(2)水平与急性冠脉综合征患者血小板聚集程度相关性分析

Correlation analysis of urine 11-DH-TXB_(2)level and platelet aggregation degree in patients with acute coronary syndrome

目的研究尿11-去氢-血栓烷B2(11-DH-TXB_(2))水平与急性冠脉综合征(ACS)患者血小板聚集程度的相关性。方法选取2019年4月至2020年12月杭州市富阳区第一人民医院收治的120例ACS患者,定义为研究组;同时选取与研究组性别、年龄相匹配的于健康体检中心体检的健康志愿者60名,定义为对照组。检测两组受试者尿11-DH-TXB_(2)水平及血小板聚集率。研究组患者根据二磷酸腺苷(ADP)诱导血小板聚集率结果分为达标组(n=30,ADP聚集率<50%)和未达标组(n=90,ADP聚集率≥50%)。采用Logistic多因素回归分析影响ACS患者血小板聚集程度的危险因素,采用Pearson相关性分析法分析尿11-DH-TXB_(2)水平与ACS患者血小板聚集率的相关性。结果研究组尿11-DH-TXB_(2)、血小板聚集率水平均高于对照组(P<0.05)。单因素分析显示,达标组性别、饮酒史、吸烟史、高血压史、糖尿病史占比,年龄、舒张压、收缩压、甘油三酯(TG)、总胆固醇(TC)、尿酸(UA)、胱抑素C(Cys C)水平与未达标组比较,差异无统计学意义(P>0.05)。未达标组体质量指数(BMI)、静息心率、D-二聚体(D-D)、低密度脂蛋白(LDL)、尿11-DH-TXB_(2)、肌钙蛋白(cTnI)、超敏C反应蛋白(hs-CRP)水平高于达标组(P<0.05)。经Logistic回归分析,静息心率、LDL、尿11-DH-TXB_(2)、hs-CRP水平均是影响ACS患者血小板聚集程度的危险因素(P<0.05)。Pearson相关性分析显示,尿11-DH-TXB_(2)水平与ACS患者血小板聚集率呈正比(r=0.552,P<0.05)。结论尿11-DH-TXB_(2)在ACS患者体内水平异常升高,与ACS患者血小板聚集程度存在一定的相关性,对判断ACS患者血小板聚集率具有临床意义。

【Objective】To study the correlation between the level of urinary 11-dehydrothromboxane B2(urinary 11-DH-TXB_(2))and the degree of platelet aggregation in patients with acute coronary syndrome(ACS).【Methods】A total of 120 ACS patients admitted to our hospital from April 2019 to December 2021 were selected and defined as the study group.At the same time,60 healthy volunteers who matched the gender and age of the study group who came to the health examination center of our hospital for physical examination were selected as the control group.The urine 11-DH-TXB_(2)level and platelet aggregation rate of the two groups of subjects were detected.According to the results of platelet aggregation induced by adenosine diphosphate(ADP),patients in the study group were divided into standard group(n=30,ADP aggregation rate<50%)and non-standard group(n=90,ADP aggregation rate≥50%).Logistic multivariate regression analysis was used to analyze the risk factors that affect the degree of platelet aggregation in ACS patients,and the Pearson correlation analysis method was used to analyze the correlation between urine 11-DH-TXB_(2)levels and platelet aggregation rate in ACS patients.【Results】The urine 11-DH-TXB_(2)and platelet aggregation rate of the study group were higher than those of the control group(P<0.05).Univariate analysis showed that when the proportion of gender,drinking history,smoking history,history of hypertension,history of diabetes,age,diastolic blood pressure,systolic blood pressure,TG,TC,UA,Cys C levels in the standard group compared with those in the non-standard group,there was no statistically significant difference(P>0.05).The levels of BMI,resting heart rate,D-D,LDL,urinary 11-DH-TXB_(2),cTnI,and hs-CRP in the substandard group were higher than those in the standard group(P<0.05).Logistic regression analysis showed that resting heart rate,LDL,urine 11-DH-TXB_(2),and hs-CRP levels were risk factors that affected the degree of platelet aggregation in patients with ACS(P<0.05).Pearson correlation analysis showed that the level of urine 11-DH-TXB_(2)was directly proportional to the platelet aggregation rate of ACS patients(r=0.552,P<0.05).【Conclusion】The level of urine 11-DH-TXB_(2)in ACS patients is abnormally elevated,which has a certain correlation with the degree of platelet aggregation in ACS patients,and has clinical significance for judging the platelet aggregation rate in ACS patients.