血浆内皮素1水平对稳定性冠心病患者的预后价值探讨  

Value of endothelin-1 in predicting the outcome of stable coronary artery disease patients

作　　者：刘媛圆 周冰洋 郭远林[1] 朱成刚[1] 吴娜琼[1] 高莹[1] 董秋婷[1] 李建军[1] Yuanyuan;Zhou Bingyang;GuoYuanlin;Zhu Chenggang;Wu Naqiong;Gao Ying;Dong Qiuting;Li Jianjun(Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037, China)

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院心内科,北京100037

出　　处：《中华老年心脑血管病杂志》2018年第6期585-588,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的研究血浆内皮素1(big endothelin-1,ET-1)对稳定性冠心病(SCAD)远期预测价值。方法连续入选3154例SCAD患者,并随访24个月,随访期间,将发生心脑血管事件的189例为事件组,未发生心脑血管事件的2965例为非事件组。酶联免疫吸附法测定基线ET-1水平,将ET-1<0.3pmol/L为低ET-1组1588例,ET-1≥0.3pmol/L为高ET-1组1566例。应用Cox回归分析评价ET-1水平对终点事件的预测价值,应用Kaplan-Meier法绘制生存曲线。结果事件组ET-1水平较非事件组明显升高[0.33(0.25,0.49)pmol/L vs 0.30(0.22,0.45)pmol/L,P=0.004]。高ET-1组临床终点事件发生率明显高于低ET-1组(7.02%vs 4.97%,P=0.015)。多因素Cox回归分析显示,ET-1为临床终点事件的预测因素(HR=1.656,95%CI:1.099~2.496,P=0.016)。KaplanMeier分析显示,高ET-1组无事件生存率较低ET-1组降低(P=0.016)。结论 ET-1为SCAD患者预后的重要危险因素,其预后判断的长期作用有待进一步研究证实。Objective To study the value of endothelin-1（ET-1）in predicting the outcome of stable coronary artery disease（SCAD）patients.Methods A total of 3154 SCAD patients who were followed up for 24 months were divided into cardiocerebral vascular events group（n=189）and cardiocerebral vascular events-free group（n=2965）.Their serum ET-1 level was measured by ELISA.The patients were further divided into ET-1 〈0.3 pmol/L group（n=1588）and ET-1≥0.3 pmol/L group（n=1566）.The value of ET-1 in predicting the end events was assessed by Cox regression analysis.The survival curve was plotted by Kaplan-Meier analysis.Results The serum ET-1 level was signify-cantly higher in cardiocerebral vascular events group than in cardiocerebral vascular events-free group（0.33 pmol/L vs 0.30 pmol/L,P=0.004）.The incidence of clinical end events was significantly lower in ET-1 ≥0.3 pmol/L group than in ET-1〈 0.3 pmol/L group（7.02% vs 4.97%,P=0.015）.Multivariable Cox regression analysis showed that ET-1 was a predictor of clinical end events（HR=1.656,95%CI：1.099-2.496,P=0.016）.KaplanMeier analysis showed that the events-free survival rate was lower in patients with a higher serum ET-1 level than in those with a lower serum ET-1 level（P=0.016）.Conclusion ET-1 is an important risk factor for the outcome of SCAD patients.Further studies are needed to confirm its long-term value in predicting the outcome of SCAD patients.

关 键 词：内皮缩血管肽1 冠心病 心血管疾病 预后 

分 类 号：R541.4[医药卫生—心血管疾病]