血清BGP、miR-17-92、sST2与CHD患者PCI术后预后的关系

Relationship between serum osteocalcin,miR-17-92,sST2 and prognosis after percutaneous coronary intervention in patients with coronary heart disease

目的探讨骨钙素(BGP)、微小RNA-17-92a(miR-17-92)可溶性生长刺激表达基因2蛋白(sST2)与冠心病(CHD)患者经皮冠状动脉介入(PCI)术后预后的关系。方法选取2020年6月至2022年6月南阳市第一人民医院收治并行PCI术的168例CHD患者作为研究组,另选取同期53例未行PCI的CHD患者作为对照组。比较两组患者的血清BGP、miR-17-92、sST2水平,研究组患者随访12个月,失访6例,依据预后情况分为预后不良组126例和预后良好组36例,采用多因素Logistic回归分析影响CHD患者PCI术后预后的危险因素;绘制受试者工作特征(ROC)曲线分析血清BGP、miR-17-92、s ST2对预后不良的预测效能。结果两组患者的血清BGP比较差异无统计学意义(P>0.05),但研究组患者的血清miR-17-92、sST2分别为1.55±0.29、(53.48±10.84)ng/mL,明显高于对照组的1.41±0.30、(20.64±5.97)ng/mL,差异均有统计学意义(P<0.05);预后不良组患者的miR-17-92、s ST2分别为1.59±0.29、(58.33±8.43)ng/mL,明显高于预后良好组的1.45±0.28、(52.15±6.86)ng/mL,而血清BGP水平为(23.06±3.84)ng/mL,明显低于预后良好组的(27.19±4.31)ng/mL,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,miR-17-92、sST2是CHD患者PCI术后预后的独立危险因素,而血清BGP是保护因素(P<0.05);ROC曲线分析结果显示,血清BGP、miR-17-92、s ST2单独及联合检测预测CHD患者PCI术后预后的曲线下面积(AUC)分别为0.783、0.628、0.723、0.856,联合预测的AUC明显高于单独预测(Z=2.897、4.627、1.984,P<0.05)。结论血清miR-17-92、sST2均是CHD患者PCI术后预后的危险因素,BGP是保护因素,监测其变化对CHD患者PCI术后预后有一定预测价值。

Objective To investigate the relationship between serum osteocalcin(BGP),MicroRNAs 17-92a(miR-17-92),soluble growth-stimulated expressed gene 2 protein(sST2)and prognosis after percutaneous coronary intervention(PCI)in patients with coronary heart disease(CHD).Methods A total of 168 CHD patients admitted to Nanyang First People's Hospital who underwent PCI from June 2020 to June 2022 were selected as the study group,and 53 CHD patients who did not undergo PCI during the same period were selected as the control group.The serum levels of BGP,miR-17-92,and sST2 were compared between the two groups,and the patients in the study group were followed up for 12 months.According to the prognosis,126 cases were divided into poor prognosis group and 36 cases into good prognosis group.Multivariate Logistic regression was used to analyze the risk factors affecting the prognosis of CHD patients after PCI.The predictive efficacy of serum BGP,miR-17-92,and sST2 on poor prognosis was analyzed by receiver operating characteristic(ROC)curve.Results There was no significant difference in serum BGP between the two groups(P>0.05).The serum miR-17-92 and sST2 levels in the study group were 1.55±0.29 and(53.48±10.84)ng/mL,respectively,which were significantly higher than 1.41±0.30 and(20.64±5.97)ng/mL in the control group(P<0.05).The miR-17-92 and sST2 levels in the poor prognosis group were 1.59±0.29 and(58.33±8.43)ng/mL,respectively,which were significantly higher than 1.45±0.28 and(52.15±6.86)ng/mL in the good prognosis group;the serum BGP level was(23.06±3.84)ng/mL,which was significantly lower than(27.19±4.31)ng/mL of the good prognosis group;the differences were statistically significant(P<0.05).Logistic regression analysis showed that miR-17-92(OR=1.023,95%CI:1.014-1.032)and sST2(OR=1.674,95%CI:1.062-2.637)were independent risk factors for prognosis after PCI in CHD patients,and serum BGP(OR=0.614,95%CI:0.395-0.957)was a protective factor(P<0.05).ROC curve analysis results showed that the area under the curve(AUC)of serum BGP,miR-17-92,sST2,and the combination of the three indexes for predicting prognosis after PCI in patients with CHD was 0.783,0.628,0.723,and 0.856,respectively,and the AUC predicted by the combination was significantly higher than that predicted by each index alone(Z=2.897,4.627,and 1.984,P<0.05).Conclusion Serum miR-17-92 and sST2 are risk factors for prognosis after PCI in patients with CHD,and BGP is a protective factor.Monitoring the changes of the three indexes has certain predictive value for prognosis after PCI in patients with CHD.