血清sST2、TG水平联合GRACE危险评分对不稳定型心绞痛患者冠脉病变程度的预测价值

The Predictive Value of Serum sST2 and TG Levels Combined with GRACE Risk Score for the Severity of Coronary Artery Disease in Patients with Unstable Angina Pectoris

目的探讨血清可溶性生长刺激表达基因2蛋白(sST2)、甘油三酯(TG)、全球急性冠脉事件注册研究(GRACE)评分与不稳定型心绞痛(UA)患者冠脉病变程度的相关性,并分析其预测价值。方法回顾性选取我院2020年11月至2022年11月收治的168例UA患者为研究对象,患者入院后均行冠脉造影检查并采用Gensini评分评估冠脉病变严重程度。根据患者病例资料计算GRACE评分并收集相关临床资料,检测血清sST2表达水平。结果根据Gensini评分结果,168例UA患者中轻度病变组49例(29.17%),中度病变组60例(35.71%),高度病变组59例(35.12%)。3组患者间TG、HDL-C、ApoA1、sST2水平和GRACE评分比较差异有统计学意义(P<0.05);经多因素Logistic回归分析表明,TG、sST2水平及GRACE评分是影响冠脉病变严重程度的独立危险因素(P<0.05)。Spearman相关性分析显示,sST2、TG水平及GRACE评分与Gensini评分呈显著正相关(r=0.777、0.842、0.883,均P<0.001)。ROC曲线分析显示sST2、TG、GRACE评分预测UA患者冠脉高度病变的曲线下面积(AUC)分别为0.786、0.719、0.766,三项指标联合预测的AUC为0.897(95%CI 0.849~0.945)。结论sST2、TG水平及GRACE评分是UA患者冠脉病变程度的独立预测因子,sST2、TG、GRACE三项指标联合评估能够显著提高对UA患者冠脉高度病变的预测价值。

Objective To investigate the correlation between serum soluble growth stimulating gene 2 protein(sST2),triglycerides(TG),global acute coronary event registry(GRACE)scores,and the degree of coronary artery disease in patients with unstable angina pectoris(UA),and to analyze their predictive value.Methods A retrospective study was conducted on 168 UA patients admitted to our hospital from November 2020 to November 2022.After admission,all patients underwent coronary angiography and the severity of coronary artery disease was evaluated using the Gensini score.The GRACE score based on patient case data was calculated,and relevant laboratory data was collected to detect the expression level of serum sST2.Results According to the Gensini score,there were 49 mild lesions(29.17%),60 moderate lesions(35.71%),and 59 high lesions(35.12%)in the 168 UA patients.There were significant differences in TG,HDL-C,ApoA1,sST2 levels and GRACE scores among the three groups of patients(P<0.05).Rank Logistic regression analysis showed that TG,sST2 levels and GRACE scores were independent risk factors affecting the severity of coronary artery disease(P<0.05).Spearman correlation analysis showed a significant positive correlation between sST2,TG levels,GRACE scores and Gensini scores(r=0.777,0.842,0.883,P<0.001).Receiver operating characteristic analysis showed that the area under the curve(AUC)predicted by the sST2,TG,and GRACE scores for the height of coronary artery lesions in UA patients were 0.786,0.719,and 0.766,respectively,and the AUC predicted by the three indicators was 0.897(95%CI 0.849~0.945).Conclusion The levels of sST2,TG,and GRACE score are independent predictors of the degree of coronary artery disease in UA patients.The combined evaluation of sST2,TG,and GRACE can significantly improve the predictive value of high coronary artery disease in UA patients.