摘要
目的探讨急性冠脉综合征(acute coronary syndrome,Acs)患者血清可溶性生长刺激表达基因蛋白2(soluble growth stimulation expression gene 2 protein,sST2),核苷酸寡聚化结构域样受体热蛋白结构域相关蛋白3(nucleotide oligomerization domain like receptor heat protein domain associated protein 3,NLRP3)水平与经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后无复流-慢血流的关系。方法选择2020年1月~2022年12月佳木斯市中心医院收治的97例急性冠脉综合征患者,所有患者均接受PCI治疗,根据术后无复流-慢血流发生情况分为无复流-慢血流组(n=20)和对照组(n=77)。术前检测血清sST2及NLRP3水平,分析影响急性冠脉综合征患者PCI术后无复流-慢血流的因素以及sST2,NLRP3预测急性冠脉综合征患者PCI术后无复流-慢血流的价值。结果无复流-慢血流组血清sST2(14.32±2.65 ng/ml vs 11.02±2.13 ng/ml),NLRP3(68.23±10.17 pg/ml vs 42.05±8.23 pg/ml)水平高于对照组,差异具有统计学意义(t=5.860,12.055,均P<0.05)。多因素Logistic回归分析显示高血栓负荷(OR:7.791,95%CI:2.834~21.421)、高水平sST2(OR=2.071,95%CI:1.146~3.743)、高水平NLRP3(OR=2.008,95%CI:1.228~3.284)是急性冠脉综合征患者PCI术后无复流-慢血流的危险因素(均P<0.05)。sST2,NLRP3诊断急性冠脉综合征患者PCI术后无复流-慢血流的临界值分别为12.91ng/ml,55.39 pg/ml,曲线下面积分别为0.737,0.686,联合sST2,NLRP3诊断急性冠脉综合征患者PCI术后无复流-慢血流的曲线下面积为0.907,高于单独诊断(Z=2.662,2.856,均P<0.05)。结论急性冠脉综合征患者血清sST2,NLRP3水平增高与PCI术后无复流-慢血流的发生有关,联合检测sST2和NLRP3可提高对术后无复流-慢血流的诊断效能。
Objective To investigate the relationship between serum soluble growth stimulation expression gene 2 protein(sST2)and nucleotide oligomerization domain like receptor heat protein domain associated protein 3(NLRP3)levels in patients with acute coronary syndrome(ACS)and postoperative no reflow or slow re-flow after percutaneous coronary intervention(PCI).Methods A total of 97 patients with acute coronary syndrome admitted to Jiamusi Central Hospital from January 2020 to December 2022 were selected.All patients received PCI treatment and were divided into no reflow or slow re-flow group(n=20)and control group(n=77)based on the occurrence of postoperative no reflow or slow re-flow.The serum levels of sST2 and NLRP3 were detected before surgery,and the factors affecting no reflow or slow re-flow in patients with acute coronary syndrome after PCI were analyzed.The value of sST2 and NLRP3 in predicting no reflow or slow re-flow in patients with acute coronary syndrome after PCI was also analyzed.Results The serum levels of sST2(14.32±2.65 ng/ml vs 11.02±2.13 ng/ml)and NLRP3(68.23±10.17 pg/ml vs 42.05±8.23 pg/ml)in the no reflow or slow re-flow group were higher than those in the control group,and the differences were statistically significant(t=5.860,12.055,all P<0.05).Multivariate logistic regression analysis showed that high thrombotic burden(OR=7.791,95%CI:2.834~21.421),high levels of sST2(OR=2.071,95%CI=1.146~3.743),and high levels of NLRP3(OR=2.008,95%CI:1.228~3.284)were risk factors for no reflow or slow re-flow in patients with acute coronary syndrome after PCI(all P<0.05).The critical values of sST2 and NLRP3 for diagnosing no reflow or slow re-flow in patients with acute coronary syndrome after PCI were 12.91 ng/ml and 55.39 pg/ml,with areas under the curve of 0.737 and 0.686,respectively.The area under the curve of combined with sST2 and NLRP3 for diagnosing no reflow or slow reflow in patients with acute coronary syndrome after PCI was 0.907,which was higher than that of individual diagnosis(Z=2.662,2.856,all P<0.05).Conclusion The elevated levels of serum sST2 and NLRP3 in patients with acute coronary syndrome were related to the occurrence of no reflow or slow re-flow after PCI.The combination of sST2 and NLRP3 could improve the diagnostic efficacy of postoperative no reflow or slow blood flow.
作者
雷锐
殷实
李志
LEI Rui;YIN Shi;LI Zhi(the Third Department of Cardiology,Jiamusi Central Hospital,Heilongjiang Jiamusi 154002,China;the Second Department of Cardiology,Jiamusi Central Hospital,Heilongjiang Jiamusi 154002,China)
出处
《现代检验医学杂志》
CAS
2024年第4期121-125,154,共6页
Journal of Modern Laboratory Medicine
基金
黑龙江卫生健康委科研课题(2020-368)。
