稳定型冠心病患者血清SAA、sST2、sCD40L变化及其对不良心血管事件的预测价值

Alterations of serum SAA,sST2 and sCD40L in patients with stable coronary artery disease and their predictive value for adverse cardiovascular events

目的分析稳定型冠心病(SCAD)患者血清淀粉样蛋白A(SAA)、可溶性生长刺激表达基因2蛋白(sST2)、可溶性白细胞分化抗原40配体(sCD40L)变化,探讨其对不良心血管事件的预测价值。方法选取2020年1月至2023年6月西安凤城医院收治的284例SCAD患者作为研究对象,根据Gensini积分将患者分为轻度组(Gensini评分≤26分,n=93)、中度组(Gensini评分27~40分,n=158)、重度组(Gensini评分>40分,n=33),比较三组血清SAA、sST2、sCD40L水平,并分析血清SAA、sST2、sCD40L对主要不良心血管事件(MACE)的预测价值。结果血清SAA、sST2、sCD40L水平:重度组>中度组>轻度组(P<0.05);MACE组血清SAA、sST2、sCD40L水平高于非MACE组(P<0.05);Logistic回归分析显示,患有糖尿病、低密度脂蛋白胆固醇(LDL)升高、SAA升高、sST2升高、sCD40L升高均为影响SCAD患者发生MACE的独立危险因素(P<0.05);ROC曲线分析显示,血清SAA、sST2、sCD40L联合预测SCAD患者MACE的AUC为0.837,高于三指标单独检测(P<0.05)。结论SCAD患者血清SAA、sST2、sCD40L水平与冠脉病变程度相关,三者对MACE的预测价值较高,可作为临床预测预后的潜在途径。

Objective To analyze the changes in serum amyloid A(SAA),soluble growth stimulating gene 2 protein(sST2),and soluble leukocyte differentiation antigen 40 ligand(sCD40L)in patients with stable coronary heart disease(SCAD),and explore their predictive value for adverse cardiovascular events.Methods A total of 284 patients with SCAD were admitted to Xi'an Fengcheng Hospital from January 2020 to June 2023.They were enrolled as research subjects.Based on Gensini scores,they were divided into the mild group(≤26 points,n=93),the moderate group(27⁃40 points,n=158)and the severe group(>40 points,n=33).The concentrations of serum SAA,sST2 and sCD40L were compared among the three groups,and their predictive value for major adverse cardiovascular events(MACE)was analyzed.Results The concentrations of serum SAA,sST2,and sCD40L in the severe group were higher than those in the moderate group and higher than those in the mild group(P<0.05).They were also higher in the MACE group compared to the non⁃MACE group(P<0.05).Logistic regression analysis showed that diabetes mellitus,elevated low⁃density lipoprotein cholesterol(LDL),elevated SAA,elevated sST2,and elevated sCD40L were independent risk factors for MACE in SCAD patients(P<0.05).ROC curve analysis showed that the AUC of serum SAA combined with sST2 and sCD40L for predicting MACE was 0.837,greater than that of each bio⁃marker individually(P<0.05).Conclusion The levels of serum SAA,sST2,and sCD40L are correlated with the severity of coronary lesions in patients with SCAD.These three levels have a high predictive value for MACE,making them a potential way to predict prognosis.