MOTS-c联合GRP78预测急性心肌梗死患者PCI术后MACE发生的价值

Value of MOTS-c Combined with GRP78 in Predicting MACE After PCI in Patients with Acute Myocardial Infarction

目的探讨MOTS-c和葡萄糖调节蛋白78(GRP78)表达水平对心肌梗死患者经皮冠状动脉介入治疗(PCI)术后主要不良心血管事件(MACE)预测价值。方法选择2019年10月至2022年10月到驻马店市中心医院进行PCI手术治疗的102例急性心肌梗死患者,所有患者均进行为期6个月随访,依据患者MACE发生情况将患者分为MACE组和非MACE组,其中MACE组患者有39例,非MACE组患者63例。应用查询病历和调查问卷等方式对两组患者的一般资料(年龄、性别、心率、体重指数、收缩压、舒张压、糖尿病史和心力衰竭病史)进行统计。应用酶联免疫吸附法对患者血清GRP78和MOTS-c水平进行检测。结果MACE组和非MACE组患者的糖尿病史、体重指数、年龄和性别差异无统计学意义(P>0.05),但是MACE组患者的收缩压和舒张压比非MACE组低(P<0.05),且MACE组患者的心力衰竭病史率和心率比非MACE组高(P<0.05)。MACE组患者的GRP78水平均比非MACE组患者高(P<0.05),而MACE组患者的MOTS-c水平低于非MACE组患者(P<0.05)。GRP78和MOTS-c预测的曲线下面积(AUC)为0.889和0.721,截断值分别为1.313、183.27μg·L^(-1),其灵敏度分别为76.48%和63.29%,特异度分别为98.21%和91.38%,两者联合诊断评估MACE的AUC为0.926,灵敏度为80.93%,特异度为97.32%。经过logistic多因素分析,GRP78>1.313μg·L^(-1)、MOTS-c≤183.27μg·L^(-1)和存在心力衰竭病史是急性心肌梗死患者PCI术后MACE发生的独立危险因素(P<0.05)。结论急性心肌梗死患者PCI术后MACE发生患者的GRP78水平升高,MOTS-c水平降低,GRP78联合MOTS-c对急性心肌梗死患者PCI术后MACE发生有预测价值。

Objective To explore the value of MOTS-c and glucose-regulatory protein 78(GRP78)expression levels in predicting major adverse cardiovascular events(MACE)in patients with myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 102 patients with acute myocardial infarction who underwent PCI surgery in Zhumadian Central Hospital from October 2019 to October 2022 were selected,and all patients were followed up for six months.According to the occurrence of MACE,patients were divided into MACE group and non-MACE group,including 39 patients in MACE group and 63 patients in non-MACE group.General data(age,gender,heart rate,BMI,systolic blood pressure,diastolic blood pressure,history of diabetes and history of heart failure)of the two groups were analyzed by means of medical record inquiry and questionnaire.Serum GRP78 and MOTS-c levels were detected by enzyme-linked immunosorbent assay.Results There were no differences in the diabetes history,body mass index,age and gender the MACE and non-MACE groups(P>0.05),but the systolic and diastolic blood pressures of the MACE group were lower than those of the non-MACE group(P<0.05),and the history rate of heart failure and heart rate of the MACE group were higher than those of the non-MACE group(P<0.05).The level of GRP78 in MACE group was higher than that in non-MACE group(P<0.05),while the level of MOTS-c in MACE group was lower than that in non-MACE group(P<0.05).The area under the curve(AUC)distributions predicted by GRP78 and MOTS-c were 0.889 and 0.721,and the cut-off values were 1.313 and 183.27μg·L^(-1),respectively and the sensitivity were 76.48% and 63.29%,respectively,and specificity were 98.21% and 91.38%,respectively.The AUC,sensitivity and specificity of the combination of the two for the diagnosis of MACE were 0.926,80.93% and 97.32%,respectively.Logistic multivariate analysis showed that GRP78>1.313μg·L^(-1),MOTS-c≤183.27μg·L^(-1) and history of heart failure were independent risk factors for MACE in patients with acute myocardial infarction after PCI(P<0.05).Conclusion The level of GRP78 increased and the level of MOTS-c decreased in patients with MACE after PCI in patients with acute myocardial infarction.GRP78 combined with MOTS-c has predictive value for the occurrence of MACE after PCI in patients with acute myocardial infarction.