急性冠状动脉综合征患者血清Reg3β、OSM水平的变化及临床意义

Changes in serum Reg3βand OSM levels and clinical significance in patients with acute coronary syndrome

目的探讨急性冠状动脉综合征(ACS)患者血清再生胰岛衍生蛋白3β(Reg3β)、抑瘤素M(OSM)水平的变化及临床意义。方法选取2021年9月—2022年12月海南医学院附属海南医院/海南省人民医院急诊科收治ACS患者183例为ACS组,同期医院健康体检者65例为健康对照组,再根据随访12个月预后将ACS患者分为不良预后亚组(52例)和良好预后亚组(131例)。采用酶联免疫吸附法检测血清Reg3β、OSM水平;Spearman相关性分析ACS患者血清Reg3β与OSM水平的相关性;多因素Logistic回归和ROC曲线分析ACS患者不良预后的危险因素及血清Reg3β、OSM水平对其预测价值。结果与健康对照组比较,ACS组血清Reg3β、OSM水平升高(t/P=7.748/<0.001、9.450/<0.001);183例ACS患者12个月不良预后发生率为28.42%(52/183);与良好预后亚组比较,不良预后亚组血清Reg3β、OSM水平升高(t/P=7.390/<0.001、7.087/<0.001);ACS患者血清Reg3β与OSM水平呈正相关(r s/P=0.793/<0.001);年龄增加、KILLIP分级≥Ⅱ级、Gensini评分增加和Reg3β升高、OSM升高是ACS患者不良预后的独立危险因素[OR(95%CI)=1.071(1.008~1.138)、3.709(1.186~11.600)、1.045(1.022~1.067)、1.014(1.007~1.021)、1.007(1.004~1.010)];血清Reg3β、OSM水平及二者联合预测ACS患者不良预后的曲线下面积(AUC)分别为0.784、0.789、0.861,二者联合的AUC大于血清Reg3β、OSM水平单独预测(Z/P=2.955/0.003、2.696/0.007)。结论ACS患者血清Reg3β、OSM水平升高,并与不良预后密切相关,且二者联合预测ACS患者不良预后的价值较高。

Objective To investigate the changes and clinical significance of serum regenerated islet-derived protein 3β(Reg3β)and oncostatin M(OSM)levels in patients with acute coronary syndrome(ACS).Methods One hundred and eighty-three patients with ACS admitted to the Department of Emergency of Hainan Affiliated Hospital of Hainan Medical University/Hainan General Hospital from September 2021 to December 2022 were selected as the ACS group,and sixty-five healthy people who underwent physical examination in the hospital during the same period were selected as the healthy control group,and then the patients with ACS were divided into poor prognosis subgroup(52 cases)and good prognosis subgroup(131 cases)according to prognosis.Serum Reg3βand OSM levels were detected by enzyme-linked immunosorbent assay;Spearman correlation analysis was performed to analyze the correlation between serum Reg3βand OSM levels in patients with ACS;and factors of poor prognosis and the predictive value of serum Reg3βand OSM levels in patients with ACS were analyzed by multifactorial Logistic regression and ROC curve.Results Compared with the healthy control group,serum Reg3βand OSM levels were elevated in the ACS group(t/P=7.748/<0.001,9.450/<0.001).The incidence rate of 12-month poor prognosis in 183 ACS patients was 28.42%(52/183),and compared with the good prognosis subgroup,the poor prognosis subgroup had elevated serum Reg3βand OSM levels(t/P=7.390/<0.001,7.087/<0.001).Serum Reg3βwas positively correlated with OSM levels in patients with ACS(r s/P=0.793/<0.001).The independent risk factors for poor prognosis in patients with ACS were increased age,KILLIP classification≥gradeⅡ,increased Gensini score and elevated Reg3β,elevated OSM[OR(95%CI)=1.071(1.008-1.138),3.709(1.186-11.600),1.045(1.022-1.067),1.014(1.007-1.021),1.007(1.004-1.010)].Serum Reg3β,OSM levels,and the combination of the two predicted the area under the curve(AUC)of poor prognosis in ACS patients were 0.784,0.789,and 0.861,respectively,and the AUC of the combination of the two was better than that for the serum Reg3βand OSM levels alone(Z/P=2.955/0.003,2.696/0.007).Conclusion Serum Reg3βand OSM levels are elevated in ACS patients and are closely associated with poor prognosis,and the combination of the two have high value in predicting poor prognosis in ACS patients.