摘要
目的探讨生长和分化因子5(growth and differentiation factor 5,GDF-5)和几丁质酶3样蛋白1(chitinase 3-like protein-1,CHI3L1)表达水平与急性心肌梗死患者预后的关系。方法选取2021年12月至2022年12月,在西安市人民医院接收的急性心肌梗死患者97例,作为急性心肌梗死组,并选择同期健康的60名体检者作为对照组,收集患者一般资料及实验室检查结果。采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测血清中GDF-5和CHI3L1的表达水平,并用心动超声图评估患者的心脏功能。根据患者随访6个月后是否出现主要不良心血管事件(major adverse cardiovascular events,MACE),将患者分为预后良好组(n=72)和预后不良组(n=25)。分析血清GDF-5及CHI3L1表达与急性心肌梗死患者心功能及患者预后的关系。结果急性心肌梗死患者血清GDF-5、CHI3L1水平显著高于健康对照组。KillipⅢ级心功能患者血清GDF-5、CHI3L1水平显著高于Ⅱ级和Ⅰ级。预后不良组患者血清GDF-5、CHI3L1、NT-pro BNP及CK-MB表达水平显著高于预后良好组。Pearson相关性分析结果显示,CHI3L1与NT-pro BNP和CK-MB呈正相关,与LVFS和LVEF呈负相关。Logistic回归分析结果显示,NT-pro BNP、CK-MB、GDF-5、CHI3L1是影响患者预后的独立危险因素。ROC结果显示,当GDF-5表达水平截断值为325.14 ng/mL时,预测急性心肌梗死患者预后的结果曲线下面积为0.896,敏感度为73.84%,特异性为81.26%。当CHI3L1表达水平截断值为347.19 ng/mL时,敏感度为68.42%,特异性为76.85%。当两者联合检测预测急性心肌梗死患者预后的ACU为0.916时,敏感度为89.4%,特异性为85.2%。结论血清GDF-5和CHI3L1水平与急性心肌梗死患者心功能及预后密切相关,联合检测具有较高预测价值。
Objective To investigate the relationship between the expression levels of growth and differentiation factor 5(GDF-5)and chitinase 3-like protein-1(CHI3L1)and prognosis in patients with acute myocardial infarction(AMI).Methods A total of 97 patients with AMI received in Xi'an People's Hospital from January 2021 to December 2022 were selected as the AMI group,and 60 healthy subjects in the same period were selected as the control group.The expression levels of GDF-5 and CHI3L1 in serum were detected by enzyme linked immunosorbent assay(ELISA),and cardiac function was evaluated by cardiac color ultrasound.Patients were divided into a good prognosis group(72 patients)and a poor prognosis group(25 patients)according to whether major adverse cardiovascular events(MACE)occurred after 6 months of follow-up.The relationship between serum GDF-5 and CHI3L1 expression and cardiac function and prognosis in patients with AMI were analyzed.Results The levels of GDF-5 and CHI3L1 in patients with AMI were significantly higher than those in the healthy control group.The levels of GDF-5 and CHI3L1 in Killip GradeⅢpatients were significantly higher than those in Grade Ⅱ and Ⅰ patients.The expression levels of GDF-5,CHI3L1,NT-pro BNP and CK-MB in the poor prognosis group were significantly higher than those in the good prognosis group.Pearson correlation analysis showed that CHI3L1 was positively correlated with NT-pro BNP and CK-MB,and negatively correlated with LVFS and LVEF.Logistic regression analysis showed that NT-proBNP,CK-MB,GDF-5 and CHI3L1 were independent risk factors for prognosis.ROC results showed that when the cut-off value of GDF-5 expression level was 325.14 ng/mL.The outcome area under the curve for predicting the prognosis of patients with AMI was 0.896,the sensitivity was 73.84%,and the specificity was 81.26%.When the cut-off value of CHI3L1 expression level is 347.19 ng/mL,the sensitivity was 68.42%and the specificity is 76.85%.When the ACU for predicting the prognosis of patients with acute myocardial infarction is 0.916,the sensitivity is 89.4%and the specificity is 85.2%.Conclusion The levels of serum GDF-5 and CHI3L1 are closely related to cardiac function and prognosis in patients withAMI,and combined detection has high predictive value.
作者
刘芳
LIU Fang(Shaanxi Normal University Xuefu Hospital,Xi'an 710001,China)
出处
《延安大学学报(医学科学版)》
2025年第4期56-60,106,共6页
Journal of Yan'an University:Medical Science Edition
关键词
急性心肌梗死
生长和分化因子5
几丁质酶3样蛋白1
预后
Acute myocardial infarction
Growth and differentiation factor 5
Chitinase 3-like protein 1
Prognosis
