血清sST2、CRP及S1P在冠状动脉临界病变患者中的水平及其临床意义

The Levels and Clinical Significance of Serum sST2,CRP,and S1P in Patients with Critical Coronary Artery Disease

目的:探究血清可溶性生长刺激表达基因2蛋白(sST2)、C反应蛋白(CRP)以及1–磷酸鞘氨醇(S1P)在冠状动脉临界病变患者中的水平及其临床意义。方法:选择2021年7月至2023年7月在河南大学第一附属医院确诊为冠状动脉临界病变的90例患者为观察组,另取同期心电图存在明确缺血性病变,但经冠状动脉造影示无狭窄的90例患者为对照组,比较两组患者血清sST2、CRP及S1P水平差异,采用相关性分析探究观察组患者血清sST2、CRP、S1P水平与其Gensini评分关联。并将观察组患者按照是否出现功能性心肌缺血区分亚组,并分析其危险因素。结果:观察组患者血清sST2、CRP及S1P水平均显著高于对照组,差异具有统计学意义(P<0.05)。观察组患者的血清sST2、CRP及S1P水平与其Gensini评分均呈正相关(r=0.3811,r=0.3788,r=0.6162,P均<0.001);观察组中缺血亚组患者血清sST2、CRP、S1P水平显著高于无缺血亚组,差异具有统计学意义(P<0.05);多因素Logistic回归分析显示,血清sST2、CRP、S1P水平是冠状动脉病变患者心肌缺血独立危险因素(P<0.05)。结论:冠状动脉临界病变患者血清sST2、CRP、S1P水平有异常升高,与患者的冠状动脉血管病变狭窄程度相关,且血清sST2、CRP、S1P水平异常升高是冠状动脉临界病变患者功能性心肌缺血的独立危险因素。

Objective To investigate the expression and clinical significance of serum soluble growth stimulating gene 2 protein expression(sST2),C-reactive protein(CRP)and sphingosine-1-phosphate(S1P)in patients with critical coronary artery disease.Methods A total of 90 patients diagnosed with critical coronary artery disease in the First Affiliated Hospital of Henan University from July 2021 to July 2023 were selected as the observation group,and another 90 patients with definite ischemic lesions on electrocardiogram but no stenosis by coronary angiography were selected as the control group.The differences in serum sST2,CRP,and S1P levels between the two groups were compared,and correlation analysis was used to explore the correlation between serum sST2,CRP,S1P levels in the observation group and their Gensini scores,and the observation group was divided into subgroups based on whether functional myocardial ischemia occurred and their risk factors were analyzed.Results The serum levels of sST2,CRP,and S1P in the observation group were significantly higher than those in the control group,with statistical significances(P<0.05).The serum levels of sST2,CRP and S1P in the observation group were positively correlated with Gensini score(r=0.3811,r=0.3788,r=0.6162,P<0.001).In the observation group,the serum levels of sST2,CRP,and S1P in the ischemic subgroup were significantly higher than those in the non-ischemic subgroup,with statistical significance(P<0.05).Multivariate logistic regression analysis showed that serum sST2,CRP,and S1P levels were independent risk factors for myocardial ischemia in patients with coronary artery disease(P<0.05).Conclusion The abnormal elevation of serum sST2,CRP,and S1P levels in patients with critical coronary artery disease is related to the degree of coronary artery stenosis,and the abnormal elevation of serum sST2,CRP,and S1P levels is an independent risk factor for functional myocardial ischemia in patients with critical coronary artery disease.