可溶性生长刺激表达基因2蛋白与冠状动脉粥样硬化病变的相关性

Correlation of plasma soluble growth stimulation expressed gene 2 level with coronary atherosclerosis

目的 :探讨冠状动脉(冠脉)粥样硬化性心脏病(冠心病)患者血浆可溶性生长刺激表达基因2蛋白(soluble growth stimulation expressed gene 2,sST2)浓度与冠心病的严重程度、稳定性及粥样硬化病变复杂性之间的关系。方法:随机选取我院心内科2014年10月至2018年7月间因怀疑冠心病收治入院的204例患者为研究对象,由冠脉造影结果分为冠心病组(148例)与非冠心病组(56例),其中冠心病组进一步根据临床表现分为急性冠脉综合征组(acute coronary syndrome,ACS)(87例)、稳定性心绞痛组(stable angina pectoris,SAP)(61例);根据造影结果对冠脉狭窄程度进行Gensini评分,再根据冠脉斑块病变形态分为复杂病变和简单病变2个亚组。采用酶联免疫吸附测定(enzyme linked immunosorbent assay,ELISA)法测定血浆sST2浓度,进行统计学分析。结果:冠心病组血浆sST2浓度明显高于对照组(P<0.001)。ACS组血浆sST2水平显著高于SAP组(P=0.002)及非冠心病组(P<0.001)。ACS组中复杂病变患者的血浆sST2水平显著高于简单病变患者(P=0.001)。Spearman相关分析显示血浆sST2浓度与Gensini评分呈正相关(r=0.239,P=0.001)。多元逐步回归分析显示病变类型(简单/复杂)、血清肌钙蛋白(troponin Ⅰ,TnI)水平是血浆sST2水平升高的危险因素(病变类型:β=0.242,P=0.003;TNI:β=0.283,P=0.001)。sST2诊断ACS患者为复杂病变的受试者工作特征(receiver operating characteristic,ROC)曲线下面积为0.713(P=0.001)。结论:血浆sST2可作为协助判断动脉粥样硬化斑块稳定性及复杂程度的一种新的可能的血清学指标。

Objective To investigate the correlation between plasma soluble growth stimulation expressed gene(sST2)level and the severity,stability of coronary artery disease(CAD)detected by angiography and the complexity of atherosclerotic lesion.Methods A total of 204 patients of whom 87 had acute coronary syndrome(ACS),61 had stable angina pectoris(SAP)and 56 control subjects who had undergone coronary angiography(CAG)between October 2014 and July 2018 were enrolled.Patients with ACS and SAP were divided into simple or complex lesion according to the complexity of atherosclerotic lesion.Plasma level of sST2 was measured by enzyme linked immunosorbent assay(ELISA)and Gensini score was calculated.All data collected were statistical analyzed.Results Plasma sST2 level was significantly elevated in patients with CAD compared with the control group(P<0.001).Level of sST2 in patients with ACS was significantly higher than those of SAP(P=0.002)and control subjects(P<0.001).Plasma sST2 level in patients with ACS with complex lesion was significantly higher than those with a simple lesion(P=0.001).There was a weak positive correlation between plasma sST2 level and severity of CAD as determined with Gensini score(r=0.239,P=0.001).Multivariate stepwise regression analysis showed that complex lesion and serum troponinⅠ(TnI)level were independent factors of plasma sST2 level(complex lesion:standardized coefficientβ=0.242,P=0.003;TnI level:standardized coefficientβ=0.283,P=0.001).The area under receiver operating characteristic(ROC)curve of sST2 for the diagnosis of ACS with complex lesion was 0.713(P=0.001).Conclusions Plasma sST2 level can be used as a new possible marker to assess the stability and complexity of atherosclerotic plaques.