sST2、NLR与冠心病预测诊断及严重程度相关性分析

Correlation of sST2 and NLR with the diagnosis and severity of coronary artery disease

目的 探讨血清可溶性生长刺激表达基因2蛋白(sST2)、中性粒细胞计数/淋巴细胞计数(NLR)水平对于冠状动脉粥样硬化性心脏病(CHD)诊断意义及其病变严重程度相关性。方法 收集2020年5月至2021年10月因胸痛就诊于蚌埠医学院第一附属医院心血管内科并接受冠状动脉造影的患者作为研究对象;根据入选标准,纳入CHD组(196例),同时选取冠脉造影正常患者纳入对照组(100例),其中CHD组患者根据相应诊断标准,又分为急性心肌梗死(AMI)组56例,不稳定型心绞痛(UA)组76例和稳定型心绞痛(SA)组64例。所有组别均行血清sST2及NLR检测,比较各组间一般资料、生化检查、血清sST2及NLR水平差异。应用二元Logistic分析CHD的独立预测因子;应用ROC曲线评估二者预测CHD的效能;并分析其与冠状动脉病变严重程度(Gensini积分)的相关性。结果 CHD组sST2及NLR水平均高于对照组,差异有统计学意义(Z=-10.55、-8.76,均P<0.05);二元Logistic分析显示sST2、NLR为冠心病的独立预测因子(P<0.05);sST2、NLR水平在AMI组>UA>SA组,差异均有统计学意义(H=50.47、35.95,均P<0.05);ROC曲线显示:sST2、NLR二者联合预测CHD其AUC为0.91,相应的灵敏度为83.70%、特异度为93.00%,优于单一检测(P<0.05);Spearman相关性显示:sST2、NLR水平随着冠状动脉Gensini评分增高而逐渐升高(P<0.05)。结论 sST2及NLR水平可作为预测CHD敏感、有效的生物学指标,二者水平更与CHD严重程度存在正相关。

Objective To investigate the significance of serum soluble growth-stimulated expression gene 2 protein(sST2)and neutrophil count/lymphocyte count(NLR)levels for the diagnosis of coronary artery atherosclerotic heart disease(CHD)and their correlation with the severity of lesions.Methods Patients who visited the Department of Cardiovascular Medicine of the First Affiliated Hospital of Bengbu Medical College for chest pain and underwent coronary angiography from May 2020 to October 2021 were collected as study subjects.According to the inclusion criteria,the CHD group(196 cases)was included,while patients with normal coronary angiography were selected as the control group(100 cases).According to the corresponding diagnostic criteria,the patients in the CHD group were subdivided into the acute myocardial infarction(AMI)group(56 cases),the unstable angina(UA)group(76 cases)and the stable angina(SA)group(64 cases).All groups were tested for serum sST2 and NLR.General data,biochemical tests,serum sST2 and NLR levels were compared among the groups.Binary logistic analysis was applied to analyze the independent predictors of CHD;ROC curves were applied to assess the efficacy of the indexes in predicting CHD;Their correlation with the severity of coronary artery lesions(Gensini score)was analyzed.Results The levels of sST2 and NLR were higher in the CHD group than that in the control group,and the differences were statistically significant(Z=-10.55、-8.76,P<0.05).Binary logistic analysis showed that sST2 and NLR were independent predictors of coronary heart disease(P<0.05).The sST2 and NLR levels were statistically significant in the AMI group>UA>SA group(H=50.47,35.95,P<0.05).The ROC curve showed that the combination of sST2 and NLR predicted CHD with an AUC of 0.91,corresponding to a sensitivity of 83.70%and specificity of 93.00%,which was superior to that of a single assay(P<0.05).Spearman's correlation test showed that the levels of sST2 and NLR increased gradually with the increase of coronary Gensini score(P<0.05).Conclusion The levels of sST2 and NLR can be used as sensitive and effective biological indicators in predicting CHD,and the levels of both are positively correlated with the severity of CHD.