冠状动脉慢血流患者血清Salusin-α、Salusin-β表达水平及预测价值

Study on the expression level and predictive value of serum Salusin-αand Salusin-βin patients with coronary slow flow

目的研究冠状动脉慢血流(CSF)患者血清Salusin-α、Salusin-β水平及对CSF的预测价值。方法选取2019年6月—2022年6月内蒙古自治区人民医院心内科行冠状动脉造影(CAG)检查提示冠状动脉无明显狭窄的108例患者的临床资料,根据心肌梗死溶栓试验(TIMI)血流分级分为CSF组(TIMI≤2级,66例)和非CSF组(TIMI 3级,42例)。采用酶联免疫吸附试验检测血清Salusin-α及Salusin-β水平。Pearson线性相关分析血清Salusin-α、Salusin-β水平与临床指标的相关性。多因素Logistic回归分析影响CSF发生的因素。受试者工作特征曲线分析血清Salusin-α、Salusin-β及二者联合检测对CSF的预测价值。结果CSF组血清Salusin-β,吸烟史比例、血尿酸、左前降支(LAD)、左回旋支(LCX)、右冠状动脉(RCA)帧数及3支冠状动脉平均帧数均明显高于非CSF组(χ^(2)/t/P=16.702/<0.001、7.013/0.008、7.917/<0.001、12.074/<0.001、9.344/<0.001、13.627/<0.001、10.476/<0.001),而血白蛋白、血清Salusin-α水平低于非CSF组(t/P=8.084/<0.001、19.189/<0.001)。血清Salusin-α与血尿酸、LAD帧数、LCX帧数、RCA帧数、平均帧数呈负相关(r/P=-0.708/<0.001、-0.769/<0.001、-0.662/<0.001、-0.635/<0.001、-0.708/<0.001),与血白蛋白呈正相关(r/P=0.667/<0.001)。血清Salusin-β与血尿酸、LAD帧数、LCX帧数、RCA帧数、平均帧数呈显著正相关(r/P=0.748/<0.001、0.676/<0.001、0.753/<0.001、0.642/<0.001、0.776/<0.001),与血白蛋白呈负相关(r/P=-0.589/<0.001)。吸烟史、Salusin-β高是影响CSF发生的独立危险因素,血白蛋白高、Salusin-α高是其保护因素[OR(95%CI)=1.464(1.146~1.870)、1.536(0.928~2.548)、0.819(0.710~0.942)、0.715(0.582~0.878)]。血清Salusin-α、Salusin-β及二者联合预测CSF的AUC分别为0.840、0.782、0.896,二者联合优于各自单独预测效能(Z=4.561、4.103,P=0.005、<0.001)。结论CSF患者血清Salusin-α降低、Salusin-β升高,两者与CSF病情程度有关,血清Salusin-α与Salusin-β联合对CSF具有较高的预测价值。

Objective To investigate the levels of serum Salusin-αand Salusin-βin patients with coronary slow flow(CSF)and their predictive value for CSF.Methods Clinical data of 108 patients who underwent coronary angiography(CAG)examination in the Department of Cardiology,Inner Mongolia Autonomous Region People's Hospital from June 2019 to June 2022 and showed no obvious stenosis of the coronary artery were selected.According to the blood flow classification of the myocardial infarction thrombolysis test(TIMI),they were divided into CSF group(TIMI grade 2 and below,66 cases)and control group(TIMI grade 3,42 cases).Enzyme-linked immunosorbent assay was used to measure the serum levels of Salusin-αand Salusin-β.Pearson linear correlation analysis was used to analyze the correlation between serum Salusin-α,Salusin-βlevels and clinical indicators.Multivariate Logistic regression analysis was used to analyze the risk factors for CSF.Receiver operating characteristic curve was used to analyze the predictive value of serum Salusin-α,Salusin-βand their combination for CSF.Results Serum Salusin-β,smoking history,serum uric acid,left anterior descending artery(LAD),left circumflex artery(LCX),right coronary artery(RCA)frame count and average frame count of three coronary arteries in CSF group were significantly higher than those in control group(χ^(2)/t/P=16.702/<0.001,7.013/0.008,7.917/<0.001,12.074/<0.001,9.344/<0.001,13.627/<0.001,10.476/<0.001),while serum albumin and serum Salusin-αlevels were lower than those of the control group(t/P=8.084/<0.001,19.189/<0.001).Serum Salusin-αwas negatively correlated with serum uric acid,LAD frame count,LCX frame count,RCA frame count and average frame count(r/P=-0.708/<0.001,-0.769/<0.001,-0.662/<0.001,-0.635/<0.001,-0.708/<0.001)and positively correlated with serum albumin(r/P=0.667/<0.001).Serum Salusin-βwas positively correlated with serum uric acid,LAD frame count,LCX frame count,RCA frame count and average frame count(r/P=0.748/<0.001,0.676/<0.001,0.753/<0.001,0.642/<0.001,0.776/<0.001),and negatively correlated with serum albumin(r/P=-0.589/<0.001).Smoking history and Salusin-βwere independent risk factors for CSF,while serum albumin and Salusin-αwere protective factors[OR(95%CI)=1.464(1.146-1.870),1.536(0.928-2.548),0.819(0.710-0.942),0.715(0.582-0.878),P<0.05].The AUC of serum Salusin-α,Salusin-β,and their combination for predicting CSF was 0.840,0.782,and 0.896,respectively,and the combination of the two was better than each of them alone(Z=4.561,4.103,P=0.005,<0.001).Conclusion Serum Salusin-αis decreased and Salusin-βis increased in patients with CSF,which are related to the severity of CSF.The combination of serum Salusin-αand Salusin-βhas a high predictive value for CSF.