血清膜联蛋白A1、集落刺激因子2受体α水平与急性心肌梗死患者预后的关系

Relationship between serum annexin A1 and colony stimulating factor 2 receptorαlevels and the prognosis of patients with acute myocardial infarction

目的探讨急性心肌梗死患者血清膜联蛋白A1(AnxA1)、集落刺激因子2受体α(CSF2RA)的表达水平与预后的关系。方法选取2018年1月至2021年12月在荆门市中医医院接受治疗的急性心肌梗死患者141例,根据患者预后是否发生不良心血管事件,将141例急性心肌梗死患者分为预后良好组57例和预后不良组84例。采用酶联免疫吸附法检测各组血清AnxA1和CSF2RA的表达水平;采用Pearson相关性分析血清AnxA1和CSF2RA表达水平的相关性,应用Logistic回归分析急性心肌梗死患者预后的影响因素,受试者工作特征(ROC)曲线评估血清AnxA1与CSF2RA水平预测急性心肌梗死患者预后不良的价值。结果预后不良组左心室射血分数低于预后良好组,差异有统计学意义(t=4.516,P<0.01);预后不良组肌钙蛋白I高于预后良好组,差异有统计学意义(t=11.546,P<0.01)。与预后良好组相比,预后不良组血清AnxA1、CSF2RA表达水平升高,差异有统计学意义(t=9.225、8.672,P<0.01)。采用Pearson相关性分析结果显示,急性心肌梗死患者AnxA1与CSF2RA表达呈正相关(r=0.497,P<0.01)。ROC曲线结果发现,血清AnxA1与CSF2RA预测急性心肌梗死患者预后不良的曲线下面积(AUC)分别为0.897、0.887,敏感度为78.60%、76.20%,特异度为94.70%、93.00%,两者联合预测急性心肌梗死患者预后不良的AUC为0.956,高于两者单一预测(Z=2.106、1.899,P<0.01)。Logistic回归分析结果显示,AnxA1、CSF2RA高表达均是影响急性心肌梗死预后的危险因素(OR=1.546、1.723,P<0.05)。结论急性心肌梗死患者血清中AnxA1、CSF2RA的表达水平升高,与患者预后不良密切相关,且两者联合对于预测AMI患者的预后不良具有较高的临床价值。

Objective To explore the relationship between the expression levels of serum annexin A1(AnxA1)and colony stimulating factor 2 receptorα(CSF2RA)and the prognosis of patients with acute myocardial infarction(AMI).Methods A total of 141 AMI patients who received treatment at Jingmen Hospital of Traditional Chinese Medicine from January 2018 to December 2021 were selected.According to whether adverse cardiovascular events occurred in the prognosis of patients,141 AMI patients were divided into the good prognosis group(57 cases)and the poor prognosis group(84 cases).The expression levels of serum AnxA1 and CSF2RA in each group were detected by enzymelinked immunosorbent assay.Pearson correlation analysis was used to analyze the correlation between the expression levels of serum AnxA1 and CSF2RA.Logistic regression was used to analyze the factors influencing the prognosis of AMI patients.Receiver operating characteristic(ROC)curve was employed to assess the value of serum AnxA1 and CSF2RA levels in predicting poor prognosis in AMI patients.Results The left ventricular ejection fraction in the poor prognosis group was lower than that in the good prognosis group,the difference was statistically significant(t=4.516,P<0.01).Troponin I level in the poor prognosis group was higher than that in the good prognosis group,the difference was statistically significant(t=11.546,P<0.01).Compared to the good prognosis group,the poor prognosis group had elevated levels of serum AnxA1 and CSF2RA,and the differences were statistically significant(t=9.225,8.672;P<0.01).Pearson correlation analysis showed a positive correlation between the expressions of AnxA1and CSF2RA in AMI patients(r=0.497,P<0.01).ROC curve results showed that the areas under the curve(AUCs)of serum AnxA1 and CSF2RA for predicting poor prognosis in AMI patients were 0.897 and 0.887,respectively,with sensitivities of 78.60% and 76.20%,and specificities of 94.70% and 93.00%,respectively.The AUC for predicting poor prognosis in AMI patients by combining the two was 0.956,which was higher than the prediction using either marker alone(Z=2.106,1.899;P<0.01).Logistic regression analysis showed that high expressions of AnxA1 and CSF2RA were risk factors affecting the prognosis of AMI(OR=1.546,1.723;P<0.05).Conclusion Elevated serum expression levels of AnxA1 and CSF2RA are closely related to poor prognosis in AMI patients,and the combination of the two has high clinical value in predicting poor prognosis in AMI patients.