急性冠脉综合征患者血清Gal-3、TPOAb、TP53表达及PCI术后心血管事件的危险因素分析

Expressions of serum galectin-3,thyroid peroxidase antibody and tumor protein P53 and risk factors of cardiovascular events in patients with acute coronary syndrome after PCI

目的 探讨急性冠脉综合征患者血清半乳糖凝集素3(Gal-3)、甲状腺过氧化物酶抗体(TPOAb)、肿瘤蛋白P53(TP53)表达及经皮冠脉介入治疗(PCI)术后心血管事件的危险因素。方法 选择2020年1月至2022年1月于我院治疗的急性冠脉综合征患者140例进行研究,观察Gal-3、TPOAb、TP53水平变化情况,根据随访PCI术后心血管事件发生情况,分为再发组(n=32)和对照组(n=108,未发生心血管事件),收集患者临床资料,分析急性冠脉综合征患者术后心血管事件的危险因素。采用受试者工作特征曲线分析Gal-3、TPOAb、TP53在急性冠脉综合征PCI术后心血管事件的预测价值。结果单因素分析显示,两组患者性别、体质指数(BMI)、饮酒、急性冠脉综合征类型、血管病变支数、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)比较,差异无统计学意义(P>0.05);两组年龄、吸烟、糖尿病、高血压、用药依从性、血清Gal-3、TPOAb、TP53表达比较,差异有统计学意义(P<0.05);多因素非条件Logistic分析,年龄、吸烟、糖尿病、高血压、用药依从性、血清Gal-3、TPOAb、TP53均是急性冠脉综合征患者PCI术后心血管事件的独立危险因素(P<0.05);ROC结果显示,血清Gal-3预测急性冠脉综合征PCI术后发生不良心血管事件的AUC为0.878,灵敏度为79.70%,特异度为84.40%,截断值为2.76 mg/L;血清TPOAb预测急性冠脉综合征PCI术后发生不良心血管事件的AUC为0.999,灵敏度93.50%,特异度为98.10%,截断值为32.98IU/ml;血清TP53预测急性冠脉综合征PCI术后发生不良心血管事件的AUC为0.692,灵敏度为81.40%,特异度88.30%,截断值为0.56 U/ml(P<0.05)。结论 急性冠脉综合征PCI术后发生不良心血管事件中血清Gal-3、TPOAb、TP53表达异常,对不良心血管事件发生具有一定预测价值。

Objective To investigate the expressions of serum galectin-3(Gal-3),thyroid peroxidase antibody(TPOAb) and tumor protein P53(TP53),and risk factors of cardiovascular events in patients with acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI).Methods ACS patients(n=140) were chosen from Qingdao Municipal Hospital from Jan.2020 to Jan.2022.The level changes of Gal-3,TPOAb and TP53 were observed.According to incidence of cardiovascular events after PCI,all patients were divided into relapsed group(n=32)and control group(n=108,without cardiovascular events).The clinical materials were collected,and risk factors of postoperative cardiovascular events were analyzed in ACS patients.The predictive value of Gal-3,TPOAb and TP53to ACS after PCI were analyzed by using receiver operating characteristic curve(ROC curve).Results The results of single-factor analysis showed that differences in gender,body mass index(BMI),drinking,types of ACS,number of lesion vessels,triglyceride(TG),total cholesterol(TC),high-density lipoprotein-cholesterol(HDL-C) and lowdensity lipoprotein-cholesterol(LDL-C) had no statistical significance between 2 groups(P>0.05).The differences in age,smoking,diabetes,hypertension,medication compliance and expressions of serum Gal-3,TPOAb and TP53 had statistical significance between 2 groups(P<0.05).The results of multi-factor non-conditional Logistic analysis showed that age,smoking,diabetes,hypertension,medication compliance and expressions of serum Gal-3,TPOAb and TP53were independent risk factors of cardiovascular events after PCI in ACS patients(P<0.05).The results of ROC curve analysis showed that,in predicting adverse cardiovascular events after PCI in ACS patients,AUC of Gal-3 was 0.878,sensitivity was 79.70%,specificity was 84.40% and cutoff value was 2.76 mg/L,AUC of TPOAb was 0.999,sensitivity was 93.50%,specificity was 98.10% and cutoff value was 32.98 IU/ml,and AUC of TP53 was 0.692,sensitivity was 81.40%,specificity was 88.30% and cutoff value was 0.56 U/ml(P<0.05).Conclusion The expressions of serum Gal-3,TPOAb and TP53 are abnormal after occurrence of adverse cardiovascular events in ACS patients after PCI,which has some predictive value to adverse cardiovascular events.