内源性尿激酶受体对急性冠脉综合征患者经皮冠状动脉介入治疗预后的预测作用  

Predictive Value of Urokinase-type Plasminogen Activator Receptor in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

作　　者：郑振达[1] 成彩联[2] 董睿敏[1] 熊肇军[1] 赵长林[1] 钱孝贤[1] 陈璘[1] 

机构地区：[1]中山大学附属第三医院心内科,广东广州510630 [2]中山大学附属第三医院肾内科,广东广州510630

出　　处：《中山大学学报（医学科学版）》2015年第5期724-727,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2011B080701005;2010A030300001);广东省教育部产学研结合项目(2011B090400517)

摘　　要：【目的】探讨内源性尿激酶受体(u-PAR)对急性冠脉综合征患者经皮冠状动脉介入治疗(PCI)预后的预测作用。【方法】分析2005年6月-2006年8月在我院心内科行PCI的急性冠脉综合征(ACS)103例,分别检测患者入院时及入院2周后全血中性粒细胞表面u-PAR表达率,并按入院时全血中性粒细胞表面u-PAR表达率水平分组,评估发生主要不良心血管事件(MACE)包括死亡、致命性或非致命性心肌梗死的风险。【结果】平均随访6.5年,发生全因死亡12例,致命性心肌梗死2例,非致命性心肌梗死8例。全血中性粒细胞表面u-PAR表达率低、中、高组的MACE发生率分别为9.1%、17.1%、31.4%,单因素及多因素分析结果均显示全血中性粒细胞表面u-PAR表达率是MACE的独立预测因子,分别为:HR=2.15,95%CI(1.30,3.54),P=0.003;HR=2.07,95%CI(1.25,3.44),P=0.005。【结论】u-PAR对ACS患者经PCI治疗后的MACE有预测作用。【Objective】 To explore the prognostic value of urokinase-type plasminogen activator receptor（u-PAR） in predicting major adverse cardiovascular events（MACE） in the patients with acute coronary syndrome（ACS） undergoing percutaneous coronary intervention（PCI）. 【Methods】 A total of 103 patients with ACS undergoing PCI in cardiology department of the Third Affiliated Hospital of SUN Yat-sen University from Jun 2005 to Aug 2006 were enrolled. In all these patients, the expression levels of u-PAR on neutrophile were measured by flow cytometry when the cases were admitted to hospital and two weeks after. These patients were divided into three groups according to the u-PAR Levels： low u-PAR group, intermediate u-PAR group and high u-PAR group. The endpoints were all-cause mortality and fatal or nonfatal recurrent myocardial infarction（MI）. 【Results】 During a median follow-up period of 6.5years, 12 all-cause mortality, 2 fatal and 8 nonfatal recurrent MIs occurred. MACE rates of low, intermediate, and high u-PAR Levels group were 9.1%, 17.1%, and 31.4%, respectively. Both univariate analysis and multivariate analysis showed that the u-PAR was an independent predictor of MACE [HR = 2.15, 95%CI（1.30, 3.54）, P = 0.003]; [HR = 2.07, 95%CI（1.25, 3.44）, P = 0.005].【Conclusions】 u-PAR could be an independent risk predictor of major adverse cardiovascular events among patients with acute coronary syndrome undergoing percutaneous coronary intervention.

关 键 词：急性冠脉综合征 经皮冠状动脉介入治疗 尿激酶受体 

分 类 号：R54[医药卫生—心血管疾病]