稳定型心绞痛患者血清核因子E2相关因子2和激活素A表达与冠状动脉侧支循环形成的相关性研究

Correlation between the expression of serum nuclear factor-erythroid 2-related factor 2 and activin A and coronary collateral circulation formation in patients with stable angina pectoris

目的探究稳定型心绞痛患者血清核因子E2相关因子2(NRF2)和激活素A表达与冠状动脉侧支循环形成的相关性。方法收集海南医学院第一附属医院2021年1月到2023年4月期间住院治疗的80例稳定型心绞痛患者,经造影检查冠状动脉为慢性完全闭塞(CTO)患者作为研究对象,参照Rentrop分级分为侧支循环形成的不良组(n=34)、良好组(n=46)。采用ELISA法检测血清NRF2与激活素A表达水平,Gensisi评分与患者血清NRF2、激活素A表达水平的关系用Spearman法分析,ROC曲线分析血清NRF2、激活素A水平对患者侧支循环形成不良的预测价值。结果不良组血清NRF2、激活素A表达水平及Gensini评分均显著高于良好组[(2.28±0.42)ng/ml比(1.46±0.37)ng/ml、(583.67±61.25)pg/ml比(472.12±54.26)pg/ml、(45.36±5.81)分比(28.49±4.33)分,t=9.251、8.605、14.889,P<0.05];患者血清NRF2、激活素A表达水平与Gensini评分均呈正相关性(均P<0.05);血清NRF2、激活素A联合预测患者冠状动脉侧支循环形成不良的曲线下面积(AUC)为0.974,优于血清NRF2、激活素A各自单独诊断(Z二者联合-NRF2=2.345、Z二者联合-激活素A=2.639,P=0.019、P=0.008)。结论稳定型心绞痛患者血清NRF2、激活素A表达水平显著升高,且与冠状动脉狭窄严重程度呈正相关性,两者联合对患者冠状动脉侧支循环形成不良具有更高的预测价值。

Objective To investigate the correlation between serum nuclear factor-erythroid 2-related factor 2(NRF2)and activin A expression and coronary collateral circulation formation in patients with stable angina pectoris.Methods From January 2021 to April 2023,80 patients with stable angina who were hospitalized in First Affiliated Hospital of Hainan Medical College,with chronic complete occlusion(CTO)by angiography,were regarded as research subjects and separated into the good group(n=46)and the adverse group(n=34)based on Rentrop classification for collateral circulation formation.ELISA was applied to detect the expression levels of serum NRF2 and activin A;Spearman method was applied to analyze the correlation between serum NRF2 and activin A expression levels and Gensisi score;receiver operating characteristic was applied to analyze the predictive value of serum NRF2 and activin A levels for poor collateral circulation.Results The expression levels of serum NRF2,activin A,and Gensini score in the adverse group were obviously higher than those in the good group[(2.28±0.42)ng/ml vs.(1.46±0.37)ng/ml,(583.67±61.25)pg/ml vs.(472.12±54.26)pg/ml,(45.36±5.81)score vs.(28.49±4.33)score,t=9.251,8.605,14.889,P<0.05];The expression levels of serum NRF2 and activin A were positively correlated with the Gensini score(all P<0.05);the area under the curve(AUC)for predicting poor formation of coronary collateral circulation by combining serum NRF2 and activin A was 0.974,which was superior to the separate diagnosis of serum NRF2 or activin A alone(Zcombination-NRF2=2.345,Z combination-activin A=2.639,P=0.019,P=0.008).Conclusion The expression levels of serum NRF2 and activin A in patients with stable angina pectoris are obviously increased and positively related with the severity of coronary artery stenosis.The combination of the two has higher predictive value for poor formation of coronary collateral circulation in the patients.