摘要
目的分析血清鸢尾素(Irisin)、金属肽酶含血小板反应蛋白元-1(ADAMTS-1)、前蛋白转化酶枯草溶菌素9(PCSK9)与急性冠脉综合征(ACS)患者冠脉病变程度及预后的关系。方法选取2020年2月至2024年3月内蒙古自治区人民医院收治的146例ACS患者设为观察组,按照Gensini积分将患者分为轻度组(n=52)、中度组(n=55)、重度组(n=39),另选取80名同期体检无冠脉病变的志愿者为对照组,比较对照组与观察组以及不同冠脉病变程度ACS患者血清Irisin、ADAMTS-1、PCSK9水平,并分析上述血清指标与冠脉病变程度的关系;对ACS患者进行为期6个月随访,依据预后情况将其分为预后良好组(n=98)及预后不良组(n=48),分析不同预后ACS患者血清Irisin、ADAMTS-1、PCSK9水平,并以受试者工作特征(ROC)曲线分析以上血清指标对预后的预测价值。结果观察组血清Irisin水平低于对照组,ADAMTS-1、PCSK9水平高于对照组(P<0.05);血清Irisin水平:轻度组>中度组>重度组;血清ADAMTS-1、PCSK9水平:轻度组<中度组<重度组(P<0.05);Pearson相关性分析显示,血清Irisin与冠状病变程度呈负相关,血清ADAMTS-1、PCSK9与冠状病变程度呈正相关(P<0.05);预后良好组血清Irisin水平高于预后不良组,血清ADAMTS-1、PCSK9水平低于预后不良组(P<0.05);ROC曲线分析结果显示,血清Irisin、ADAMTS-1、PCSK9联合预测ACS患者预后不良的曲线下面积、特异度、灵敏度分别为0.928、0.917、0.939,均高于单一指标检测(P<0.05)。结论ACS患者血清Irisin水平下降、ADAMTS-1、PCSK9水平升高,三指标与冠脉病变程度及预后密切相关,对预后具有良好的预测价值。
Objective To analyze the relationship between serum irisin,ADAM metallopeptidase with thrombospondin type 1 motif 1(ADAMTS⁃1),proprotein convertase subtilisin/Kexin type 9(PCSK9)and the severity and prognosis of coronary artery lesions in patients with acute coronary syndrome(ACS).Methods A total of 146 patients with ACS admitted to Inner Mongolia Peoples Hospital from February 2020 to March 2024 were selected as the observation group.According to the Gensini score,the patients were divided into mild group(n=52),moderate group(n=55)and severe group(n=39).Meanwhile,80 volunteers without coronary artery lesions were selected as the control group.Serum irisin,ADAMTS⁃1 and PCSK9 levels were compared between the control group and the observation group as well as between ACS patients with different severity of coronary artery lesions.The relationship between the above serum indicators and the severity of coronary artery lesions was discussed.Patients with ACS were followed up for 6 months and were divided into the good prognosis group(n=98)and the poor prognosis group(n=48).Serum irisin,ADAMTS⁃1 and PCSK9 levels in patients with different prognoses were compared.The prognostic value of the above serum indicators was analyzed using the receiver operating characteristic(ROC)curve.Results The serum irisin level was lower,and the levels of ADAMTS⁃1 and PCSK9 were higher in the observation group compared to the control group(P<0.05).The serum irisin level decreased in sequence,while the serum ADAMTS⁃1 and PCSK9 levels increased in sequence from the mild group,to the moderate group,and finally to the severe group(P<0.05).Pearson correlation analysis found that serum irisin was negatively correlated with the severity of coronary artery lesions,while serum ADAMTS⁃1 and PCSK9 were positively correlated with the severity of coronary artery lesions(P<0.05).The serum irisin level in the good prognosis group was higher than that in the poor prognosis group,while the serum ADAMTS⁃1 and PCSK9 levels were lower than those in the poor prognosis group(P<0.05).ROC curve analysis results showed that the area under the curve,specificity and sensitivity of the combination of serum irisin,ADAMTS⁃1 and PCSK9 for predicting poor prognosis of patients with ACS were 0.928,0.917 and 0.939,respectively,which were higher than those of prediction with a single indicator(P<0.05).Conclusion The serum irisin level is decreased,and the levels of ADAMTS⁃1 and PCSK9 are elevated in patients with ACS.These three factors are closely related to the severity and prognosis of coronary artery lesions,and they have good prognostic value.
作者
宋晓鹏
石慧
陈华
常浩
任茂佳
SONG Xiaopeng;SHI Hui;CHEN Hua;CHANG Hao;REN Maojia(Department of Cardiovascular Medicine,Inner Mongolia People's Hospital,Hohhot,Inner Mongolia,China,010010)
出处
《分子诊断与治疗杂志》
2025年第8期1410-1413,共4页
Journal of Molecular Diagnostics and Therapy
基金
内蒙古自治区自然科学基金(2023WZ12)。
关键词
急性冠脉综合征
冠脉病变程度
鸢尾素
金属肽酶含血小板反应蛋白元-1
前蛋白转化酶枯草溶菌素9
Acute coronary syndrome
Severity of coronary artery lesion
Irisin
Metallopeptidase with thrombospondin type 1 motif 1
Proprotein convertase subtilisin/Kexin type 9
