组织蛋白酶S在急性冠脉综合征患者临床危险分层的价值  

The study of serum level of cathepsin S in ACS patients' risk stratification

作　　者：艾文[1] 王磊[1] 刘宗波[1] 方红城[1] 谢培益[1] 陈延伟[1] 陈菲[1] 陈少源[1] 黄于郎[1] 苏又苏[1] 

机构地区：[1]广东医学院附属南山医院心内科,深圳518052

出　　处：《中国实用医药》2013年第22期1-4,共4页China Practical Medicine

摘　　要：目的通过检测ACS患者血清组织蛋白酶S(CatS)水平,分析其与不同临床表型、冠脉病变、GRACE评分的统计学意义,探讨CatS在ACS患者临床危险分层的价值。方法纳入在本院住院并行冠脉造影确诊的冠心病患者共337例为研究对象,另取30例健康体检且DSCT正常患者为对照组,所有入组病例均检测血清CatS浓度。应用SPSS18.0统计软件分析,比较CatS水平在ACS患者不同临床分型中的差异,比较与ACS患者冠脉病变、Killip分级、GRACE评分的统计学意义。结果 ACS组患者血清CatS水平较正常对照组及稳定型心绞痛组均明显升高,差异有统计学意义(P<0.05);ACS各亚组间比较,CysC浓度不同,不稳定心绞痛(UAP)、非ST段抬高心肌梗死(NSTEMI)、ST段抬高心肌梗死(STEMI)各组CatS水平依次升高,差异具有统计学意义(P<0.05)。血清CatS水平与冠状动脉病变的支数、Killip分级、GRACE评分均呈正相关(P<0.05)。结论组织蛋白酶S与ACS患者临床危险分层密切相关,监测其水平有利于为ACS患者的治疗策略提供参考。Objective To explore the serum level of cathepsin S（Cat S）,analyze the relationship with risk stratification in patients with Acute Coronary Syndrome（ACS）.Method 337 consecutive patients with coronary heart disease（CHD） diagnosed by coronary angiography were enrolled in this study,including stable angina（SAP,n=42）,unstable angina pectoris（UAP,n=117）,acute non-ST elevation myocardial infarction（NSTEMI,n=29）,acute ST-elevation myocardial infarction（STEMI,n=177）,30 healthy subjects with normal DSCT result were selected as controls group,（CG）.Artery blood samples were drawn from femoralis artery after puncture successful in CHD patients.At the same time,venous blood samples were drawn from the antecubital vein after an overnight fast in GC.Serum concentration of Cat S was tested by ELISA method.The difference levels of Cat S were compared among types of ACS patients.The correlation between the serum level of Cat S and the count number of diseased coronary artery and GRACE score was analysed.Statistical analysis was performed by the SPSS 18.0 for Windows software.Results There were no difference of clinical basic characteristics among all groups（P＆gt; 0.05）.There was no difference of serum concentration of Cat S between SAP and CG groups.But in the ACS group,／and Cat S concentrations were higher than those in the CG and SAP groups（P＆lt; 0.05）;Cat S concentrations in STEMI group were significantly higher than those in NSTEMI and UAP（P＆lt; 0.05）.Serum level of Cat S was positively correlated with the count of diseased coronary artery.Cat S were positively correlated with GRACE score（r=0.15,P＆lt; 0.05）.The higher GRACE score,the higher Cat S level.Conclusion Cat S play important roles in the risk stratification in patients with ACS,and it may be a kind of predictors for risk of cardiovascular events.

关 键 词：组织蛋白酶S 急性冠脉综合征 危险分层 

分 类 号：R541.4[医药卫生—心血管疾病]