摘要
目的探讨血清程序化细胞死亡因子5(programmed cell death factor 5,PDCD5)、血管性血友病因子裂解蛋白酶(a disintegrin-like and metalloprotease with thrombospondin type 1 motif member 13,ADAMTS13)联合全球急性冠状动脉事件注册(Global Registry of Acute Coronary Events,GRACE)评分对急性心源性胸痛(acute cardiogenic chest pain,ACCP)的诊断及预后价值。方法选取平煤神马医疗集团总医院2022年11月—2024年11月收治的208例急性胸痛患者纳入研究,患者分为ACCP组(n=116)和非ACCP组(n=92),ELISA试剂盒检测血清PDCD5、ADAMTS13水平;ACCP患者根据GRACE评分分为低危组(n=39)、中危组(n=52)和高危组(n=25);随访ACCP患者出院预后,根据实际情况分为死亡组(n=45)和存活组(n=71);采用受试者工作特征曲线分析血清PDCD5、ADAMTS13以及GRACE评分联合对ACCP及其预后的诊断价值。结果与非ACCP组比较,ACCP组血清PDCD5水平和GRACE评分均升高,血清ADAMTS13水平降低(P<0.05);血清PDCD5、ADAMTS13水平以及GRACE评分单独及联合诊断患者发生ACCP的AUC分别为0.788、0.740、0.889、0.942,三者联合优于各自单独诊断(P<0.05);与低危组比较,中、高危组血清PDCD5水平升高,血清ADAMTS13水平降低(P<0.05);与中危组比较,高危组血清PDCD5水平升高,血清ADAMTS13水平降低(P<0.05);与生存组比较,死亡组血清PDCD5水平和GRACE评分均升高,血清ADAMTS13水平降低(P<0.05);血清PDCD5、ADAMTS13、GRACE评分单独及联合诊断ACCP患者死亡的AUC分别为0.834、0.858、0.760、0.956,联合AUC高于各指标单独AUC(P<0.05)。结论ACCP患者血清PDCD5水平升高、ADAMTS13水平降低,二者联合GRACE评分对ACCP及其预后具有较高的诊断价值。
Objective To explore the diagnostic and prognostic value of serum programmed cell death factor 5(PDCD5),a disintegrin-like and metalloprotease with thrombospondin type 1 motif member 13(ADAMTS13),and global registry of acute coronary events(GRACE)score in acute cardiogenic chest pain(ACCP).Methods A total of 208 patients with acute chest pain admitted to the General Hospital of Pingmei Shenma Group from November 2022 to November 2024 were enrolled in the study.The patients were group(n=92).ELISA kit was used to detect serum levels of PDCD5 and ADAMTS13.ACCP patients were grouped into low-risk group(n=39),medium-risk group(n=52),and high-riskgroup(n=25)based on the GRACE score.The prognosis of discharged ACCP patients was followed up and grouped into a death group(n=45)and a survival group(n=71)based on actual conditions.Receiver operating characteristic curves were applied to analyze the diagnostic value of serum PDCD5,ADAMTS13,and GRACE score combination for ACCP and its prognosis.Results Compared with the non-ACCP group,the serum PDCD5 level and GRACE score in the ACCP group increased,while the serum ADAMTS13 level decreased(P<0.05).The AUCs of PDCD5,ADAMTS13,GRACE score,and their combination for diagnosing ACCP were 0.788,0.740,0.889,and 0.942,respectively.The combined model exhibited a significantly higher diagnostic effcacy than any single indicator(P<0.05).Compared with the low-risk group,the serum PDCD5 level in the medium and high-risk groups increased,while the serum ADAMTS13 level decreased(P<0.05).Compared with the medium risk group,the high-risk group had significantly higher PDCD5 level and lower ADAMTS13 level(P<0.05).Compared with the survival group,the serum PDCD5 level and GRACE score in the death group increased,while the serum ADAMTS13 level decreased(P<O.O5).The AUC of death in ACCP patients diagnosed with serum PDCD5,ADAMTS13,and GRACE scores alone and in combination were 0.834,0.858,0.760,and 0.956,respectively.The combined AUC was higher than the individual AUC of each indicator(P<0.05).Conclusion The serum PDCD5 level are elevated and ADAMTS13 level are reduced in ACCP patients,and the combination of the two biomarkers with GRACE score has high diagnostic value for ACCP and its prognosis.
作者
沈璇
王淼
SHEN Xuan;WANG Miao(Department of Cardiovascular,General Hospital of Pingmei Shenma Group,Pingdingshan,Henan 467000,China)
出处
《医药论坛杂志》
2026年第6期571-575,共5页
Journal of Medical Forum
基金
中国平煤神马集团基层专项课题(41040220221130910E)。
关键词
程序化细胞死亡因子5
血管性血友病因子裂解蛋白酶
全球急性冠状动脉事件注册评分
急性心源性胸痛
诊断
Programmed cell death factor 5
A disintegrin-like and metalloprotease with thrombospondin type 1 motif member 13
Global registry of acute coronary events
Acute cardiogenic chest pain
Diagnosis
