不同程度冠脉病变冠心病患者血清亲环素A、可溶性生长刺激表达基因2蛋白、基质金属蛋白酶-29水平变化及其诊断价值分析

Changes and diagnostic value of serum CyPA,sST2 and MMP-29 in coronary heart disease patients with different degrees of coronary artery disease

目的:分析不同程度冠脉病变冠心病患者血清亲环素A(CyPA)、可溶性生长刺激表达基因2蛋白(sST2)、基质金属蛋白酶-29(MMP-29)水平变化及其诊断价值。方法:收集60例冠心病患者作为冠心病组,另在同一时期内的体检人员中收集50例健康者作为对照组。其中冠心病组经冠脉造影检查后,根据病变类型分为三组,即不稳定心绞痛、稳定性心绞痛以及急性心肌梗死组;根据病变支数分为三组,即单支病变、双支病变以及三支病变组;根据Gensini评分分为三组,即轻度病变、中度病变以及重度病变组。比较观察组与对照组血清CyPA、sST2、MMP-29水平;比较不同疾病类型患者血清CyPA、sST2、MMP-29水平;比较不同病变支数患者血清CyPA、sST2、MMP-29水平;比较不同病变程度患者血清CyPA、sST2、MMP-29水平;分析冠心病患者血清CyPA、sST2、MMP-29水平与病变程度的相关性及诊断价值。结果:观察组血清CyPA、sST2、MMP-29水平高于对照组(均P<0.05);三组间血清CyPA、sST2、MMP-29水平比较差异有统计学意义,且与稳定性心绞痛组比较,不稳定性心绞痛组、急性心肌梗死组更高,而急性心肌梗死组比较不稳定性心较痛组也更高(均P<0.05);三组间血清CyPA、sST2、MMP-29水平比较差异有统计学意义,且双支病变组、三支病变组比较单支病变组更高,而三支病变组比较双支病变组也更高(均P<0.05);三组间血清CyPA、sST2、MMP-29水平比较差异有统计学意义,且与轻度病变组比较,中度病变组、重度病变组更高,而与中度病变组比较,重度病变组更高(均P<0.05);经Spearman相关性分析显示,冠心病患者血清CyPA、sST2、MMP-29检测值与其病变程度具有正相关关系(均P<0.05);经ROC曲线分析,血清CyPA诊断冠心病的曲线下面积(AUC)、特异度高于sST2和MMP-29(均P<0.05)。结论:冠心病患者血清CyPA、sST2、MMP-29水平越高,冠脉病变程度越严重,CyPA、sST2、MMP-29可作为冠心病病情诊断及评估的指标之一。

Objective:To analyze the changes and diagnostic value of serum cyclophilin A(CyPA),soluble growth stimulation expressed gene 2(sST2)and matrix metalloproteinase-29(MMP-29)in coronary heart disease patients with different degrees of coronary artery lesions.Methods:The medical records of 60 patients with coronary heart disease were collected as observation group.Meanwhile,the clinical data of 50 healthy individuals(control group)who received physical examinations were collected.Patients in the observation group were divided into unstable angina pectoris group,stable angina pectoris group and acute myocardial infarction group according to the type of the lesion displayed by coronary angiography.According to the number of lesions,the patients were divided into single-vessel disease group,double-vessel disease group and three-vessel disease group.According to Gensini score,the patients were divided into mild group,moderate group and severe group.Serum CyPA,sST2 and MMP-29 levels were compared between the observation group and the control group,among patients with different disease types,among patients with different numbers of lesions,and among patients with different degrees of disease.The diagnostic value of serum CyPA,sST2 and MMP-29 levels in coronary heart disease was analyzed.Results:Serum CyPA,sST2 and MMP-29 levels in the observation group were higher than those in the control group(all P<0.05).Serum CyPA,sST2 and MMP-29 levels decreased in sequence from the acute myocardial infarction group,the unstable angina pectoris group to the stable angina pectoris group(all P<0.05).Serum CyPA,sST2 and MMP-29 levels decreased in sequence from the three-vessel disease group,the double-vessel disease group to the single-vessel disease group(all P<0.05).Serum CyPA,sST2 and MMP-29 levels decreased in sequence from the sever group,the moderate group to the mild group(all P<0.05).Spearman correlation analysis found that serum CyPA,sST2 and MMP-29 levels were positively correlated with the severity of coronary heart disease(all P<0.05).ROC curve analysis showed that the area under curve(AUC)and specificity of serum CyPA for diagnosing coronary heart disease were higher than those of sST2 and MMP-29(all P<0.05).Conclusion:The higher the serum levels of CyPA,sST2 and MMP-29 in patients with coronary heart disease,the more severe the coronary artery disease.CyPA,sST2 and MMP-29 can be used for the diagnosis and evaluation of coronary heart disease.