血浆内源性sRAGE、esRAGE、cRAGE对冠心病及其并发急性心肌梗死的诊断价值  

Diagnostic value of plasma sRAGE,esRAGE and cRAGE in coronary artery disease and coronary artery disease with acute myocardial infarction

作　　者：朱馨媛[1] 郭彩霞[1] 张立克[2] 杜凤和[1] 

机构地区：[1]首都医科大学附属北京天坛医院心内科,北京100050 [2]首都医科大学病理生理教研室

出　　处：《临床心血管病杂志》2010年第7期517-520,共4页Journal of Clinical Cardiology

基　　金：国家自然科学基金项目(No:30801217)

摘　　要：目的:探讨血浆可溶性晚期糖基化终末产物受体(sRAGE)、内源性分泌型晚期糖基化终末产物受体(esRAGE)、裂解型晚期糖基化终末产物受体(cRAGE)是否为冠心病及其并发急性心肌梗死的诊断指标。方法:选择2009-03-2009-05我院心内科住院进行冠状动脉造影检查的患者,包括非冠心病组(Ⅰ组,16例)、冠心病非心肌梗死组(Ⅱ组,22例)、冠心病急性心肌梗死组(Ⅲ组,16例),ELISA方法检测血浆sRAGE、esRAGE浓度,两者浓度之差为cRAGE浓度。结果:Ⅲ组sRAGE、esRAGE、cRAGE水平高于Ⅱ组(P<0.01)和Ⅰ组,P<0.01;Ⅲ组cRAGE分别与cTNI(P=0.009)和CK-MB(P=0.015)成正相关;sRAGE、esRAGE、cRAGE水平在Ⅱ组和Ⅰ组差异无统计学意义(P>0.05);运用ROC曲线评价sRAGE、esRAGE、cRAGE对冠心病患者并发急性心肌梗死的诊断价值,曲线下面积分别为0.855(P=0.000)、0.770(P=0.005)、0.818(P=0.001),sRAGE、esRAGE、cRAGE诊断急性心肌梗死灵敏度分别为75%、62.5%、68.8%,特异性分别为86.4%、90.9%、90.9%。结论:血浆sRAGE、esRAGE、cRAGE可能为冠心病患者并发急性心肌梗死的诊断指标。Objective：To elucidate whether plasma soluble receptor for advanced glycation end products （sRAGE）,endogenous secretory receptor for advanced glycation end products （esRAGE）,cleaved receptor for advanced glycation end products （cRAGE） are the biochemical markers indicating coronary artery disease and coronary artery disease with acute myocardial infarction （AMI）.Method：Plasma levels of sRAGE,esRAGE were determined by enzyme linked immunoabsorbent assay in patients who came from Cardiology Department of Tiantan Hospital form March to May 2009 categorized as group Ⅰ （16 non-CAD subjects）,group Ⅱ （22 CAD without myocardial infarction subjects）,and group Ⅲ （16 CAD with AMI subjects）,and the level of cRAGE equaled that of sRAGE minus esRAGE.Result：Plasma levels of sRAGE,esRAGE and cRAGE were higher in group Ⅲ than in group Ⅱ （P〈0.01） and in group Ⅰ （P〈0.01）,and the concentration of cRAGE was positively correlated with that of cTNI （P=0.009） and CK-MB （P=0.015）.However,the levels of sRAGE,esRAGE and cRAGE between group Ⅱ and group Ⅰ were of no statistical difference （P〈0.05）.Further more,to evaluate whether sRAGE,esRAGE and cRAGE are the biochemical markers indicating the AMI in CAD patients,ROC curve was used,and area under the curve was 0.855 （P=0.000）,0.770 （P=0.005）,0.818 （P=0.001） separately.The diagnostic sensitivity of sRAGE,esRAGE,cRAGE are 75%,62.5%,68.8%,and specificity are 86.4%,90.9%,90.9%.Conclusion：sRAGE,esRAGE and cRAGE may be new biochemical markers indicating AMI in the patients with coronary artery disease.

关 键 词：冠心病 可溶性晚期糖基化终末产物受体 内源性分泌型晚期糖基化终末产物受体 裂解型晚期糖基化终末产物受体 生化指标 

分 类 号：R541.4[医药卫生—心血管疾病]