急性冠脉综合征患者血清NGAL、suPAR、sOSCAR表达水平及与预后的相关性

Serum levels neutrophil gelatinase-associated apolipoprotein,soluble urokinase-type plasminogen activator receptor and soluble osteoclast-associated receptor in patients with acute coronary syndrome and their correlation with prognosis

目的 探讨血清中性粒细胞明胶酶相关载脂蛋白(NGAL)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)和可溶型破骨细胞相关受体(sOSCAR)在急性冠脉综合征(ACS)患者中表达,并分析其与患者临床预后的关系。方法 选取我科收治的ACS患者120例作为ACS组,另选取在我院体检正常的健康志愿者100例作为对照组。检测并比较2组血清NGAL、suPAR、sOSCAR表达差异。ACS患者出院后随访12个月,记录患者随访期间主要不良心血管事件(MACE)的发生情况,并将患者分为MACE组和非MACE组。采用ROC曲线,分析NGAL、suPAR、sOSCAR对ACS患者MACE的诊断效能;应用多因素logistic回归分析ACS患者MACE发生的危险因素。结果 ACS组血清NGAL、suPAR、sOSCAR值与对照组比较,差异有统计学意义(P<0.05)。MACE组血清NGAL、suPAR值高于非MACE组,血清sOSCAR值低于非MACE组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示:血清NGAL、suPAR、sOSCAR是影响ACS患者MACE发生的独立危险因素(P<0.05)。ROC曲线显示:血清NGAL、suPAR、sOSCAR及三者联合检测预测患者MACE发生的曲线下面积为0.825、0.810、0.793、0.910,敏感度为0.708、0.662、0.754、0.677,特异度为0.769、0.808、0.730、0.921。结论 ACS患者血清NGAL、suPAR升高和sOSCAR降低与疾病发生及患者预后状况相关,并对评估患者MACE发生有较高的参考价值。

Objective To measure the serum levels of neutrophil gelatinase-associated apolipoprotein(NGAL),soluble urokinase-type plasminogen activator receptor(suPAR)and soluble osteoclast-associated receptor(sOSCAR)in patients with acute coronary syndrome(ACS),and to analyze their correlation with the prognosis.Methods A total of 120 ACS patients admitted to our department(ACS group)were selected.Another 100 healthy volunteers receiving physical examinations in our hospital during the same period were enrolled in control group.Serum levels of NGAL,suPAR and sOSCAR were detected and compared.ACS patients were followed up for 12 months after discharge.Major adverse cardiovascular events(MACEs)during the follow-up period were recorded,and ACS patients were divided into MACE group and non-MACE group.The receiver-operating characteristic(ROC)curve was plotted to analyze the diagnostic efficacy of serum NGAL,suPAR and sOSCAR on MACEs in ACS patients.Multivariate logistic regression was used to analyze the risk factors of MACE in ACS patients.Results There were significant differences in serum levels of NGAL,suPAR and sOSCAR between ACS group and control group(P<0.05).Serum levels of NGAL and suPAR in the MACE group were significantly higher than those in non-MACE group,while serum sOSCAR was significantly lower(P<0.05).Multivariate logistic regression analysis showed that serum NGAL(95%CI:1.003-2.619,P<0.001),suPAR(95%CI:1.081-3.247,P=0.001),and sOSCAR(95%CI:0.377-0.854,P=0.006)were independent risk factors for MACEs in ACS patients.The ROC curve showed that the area under the curve(AUC)of serum NGAL,suPAR,and sOSCAR and their combined detection for predicting the occurrence of MACE in patients was 0.825,0.810,0.793,and 0.910,respectively,with the sensitivity of 0.708,0.662,0.754,and 0.677,and the specificity of 0.769,0.808,0.730,and 0.921,respectively.Conclusion Increased serum NGAL and suPAR and decreased serum sOSCAR in ACS patients are correlated with the occurrence and prognosis of ACS,which have references for evaluating the occurrence of MACEs.