外周血成纤维细胞激活蛋白表达水平在冠心病诊断中的作用及临床意义  

Role and Clinical Significance of the Expression Level of Activated Protein in Peripheral Blood Fibroblasts in the Diagnosis of Coronary Heart Disease

作　　者：陈涛 孟祥平 余明 张欢 范稣圳 蒋学俊[1] 徐林[1] Chen Tao;Meng Xiangping;Yu Ming(Department of Cardiovascular Medicine,The People′s Hospital of Wuhan University,Hubei 430060,China)

机构地区：[1]武汉大学人民医院心血管内科武汉大学心血管病研究所心血管病湖北省重点实验室

出　　处：《医学研究杂志》2019年第12期32-35,107,共5页Journal of Medical Research

基　　金：国家自然科学基金资助项目(面上项目)(81370283);国家自然科学基金青年科学基金资助项目(81100130)

摘　　要：目的检测冠心病(CAD)患者外周血成纤维细胞激活蛋白(cFAP)的表达水平,探讨其临床意义。方法选取2018年6~12月在武汉大学人民医院住院治疗患者,依据临床病史结合冠脉造影结果诊断为CAD者109例,其中包括急性冠状动脉综合征(ACS)和稳定性冠心病(SCAD),另选取26例同期入院体检健康者为对照组,用ELISA法检测3组患者cFAP的表达水平。结果ACS组患者吸烟史阳性率、饮酒史阳性率高于SCAD组及对照组(P<0.05);高血压阳性率高于对照组(P<0.05),与SCAD组比较差异无统计学意义(P>0.05)。ACS组患者白细胞计数(WBC)、中性粒细胞比率(NEU%)、超敏肌钙蛋白(ultra-TnI)水平均高于其余两组(P<0.05),cFAP水平明显低于其余两组(P<0.05)。ROC曲线分析结果显示,cFAP可作为CAD诊断中ACS诊断的排除依据(S=0.848,敏感度为79.2%,特异性为78.4%)。结论ACS患者cFAP的表达水平明显降低,可作为临床上CAD患者快速分型诊断的检测指标;且在一定程度上可以协同现有临床指标共同反应心肌损伤程度,或可作为ACS患者的远期预后评价指标。Objective To detect the expression level of circulating fibroblast activation protein(cFAP)in peripheral blood of coronary heart disease(CHD)patients,and to explore its clinical significance.Methods Selecting patients who were hospitalized in the People′s Hospital of Wuhan University from June 2018 to December 2018,according to the results of coronary angiography and clinical history,109 cases were diagnosed as CAD,including acute coronary syndrome(ACS)and stable coronary heart disease(SCAD),meanwhile,select 26 healthy persons as control group.The expression levels of cFAP of the three groups were measured in ELISA.Results The positive rate of smoking history and drinking history in ACS group was statistically significantly higher than those in SCAD group and control group(P<0.05).The positive rate of hypertension was higher than that of the control group(P<0.05),while no statistically significant differences between SCAD group and the control group(P>0.05).WBC,NEU%and ultra-sensitive troponin(ultra-TnI)in the ACS group were statistically significantly higher than those in the other two groups(P<0.05),and the levels of cFAP were significantly lower than those in the other two groups(P<0.05).ROC curve analysis showed that cFAP could be used as the exclusion basis for ACS diagnosis in CAD diagnosis(S=0.848,sensitivity 79.2%,specificity 78.4%).Conclusion The expression level of cFAP is significantly decreased in patients with ACS,which can be used as an indicator for rapid classification of CAD patients.To some extent,it can combined with clinical indicators to reflect the degree of myocardial injury and predict the long-term prognosis of patients with ACS.

关 键 词：冠心病 急性冠状动脉综合征 成纤维细胞激活蛋白 临床意义 

分 类 号：R541.4[医药卫生—心血管疾病]