生长停滞特异性蛋白6与急性心肌梗死的相关性研究  

Study on the relationship between growth arrest-specific protein 6 and acute myocardial infarction

作　　者：李迪[1] 吕永楠[2] 刘欢[1] 李艳[1] Li Di;Lyu Yongnan;Liu Huan;Li Yan(Department of Clinical Laboratory,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院检验医学中心,武汉430060 [2]武汉大学人民医院心血管内科,武汉430060

出　　处：《中华检验医学杂志》2020年第3期302-306,共5页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金(81772265,2017);湖北省自然科学基金(2017CFB172);武汉大学人民医院引导基金(RMYD2018M15);武汉大学医学部创新种子基金培育项目(TFZZ2018034)。

摘　　要：目的:探讨血清生长停滞特异性蛋白6(Gas6)与冠状动脉粥样硬化性心脏病(冠心病)患者发生急性心肌梗死(AMI)的关系。方法:病例对照研究。选择2018年1月至6月在武汉大学人民医院心内科住院患者为患者组,其中心绞痛患者103例,年龄(60.20±9.35)岁,AMI患者102例,年龄(58.85±9.80)岁;收集健康体检者130名,年龄(63.14±10.40)岁。利用酶联免疫法检测血清Gas6水平。Spearman法分析Gas6与冠心病危险因素的相关性,Logistic回归分析Gas6与AMI发生的关系。ROC曲线分析Gas6的诊断效能。结果:心绞痛组[13.77(10.57~17.03)ng/ml,t=2.444,P=0.025]和AMI组血清[16.22(12.70~20.09)ng/ml,t=4.965,P<0.001]Gas6水平分别高于对照组[10.92(8.90~14.92)ng/ml],差异有统计学意义。AMI组血清Gas6水平高于心绞痛组(t=3.854,P<0.001),差异有统计学意义。在剔除了高血压和糖尿病患者的敏感性分析中,AMI组(n=37)血清Gas6水平[15.05(11.08~16.20)mg/L]高于对照组[10.93(8.91~14.93)mg/L,t=3.479,P=0.001]和心绞痛组(n=42)[12.85(9.10~16.20)mg/L,t=2.639,P=0.019],差异有统计学意义。血清Gas6浓度水平与CRP、WBC、Glu和Cr呈正相关,P值分别为0.010、0.012、0.010和0.002,相关系数分别为0.194、0.176、0.180和0.120。在充分调整了协变量后,Logistic回归表明Gas6水平与AMI的发生呈正相关[OR值及95%CI为1.080(1.012~1.152),P=0.020]。Gas6诊断AMI的ROC曲线下面积及其95%CI为0.648(0.572~0.723)。结论:血清Gas6浓度水平在AMI患者中显著增高,并且其浓度水平与AMI的发生呈正相关。Objective To explore the relationship between growth arrest-specific protein 6(Gas6)and acute myocardial infarction(AMI).Methods Patients were included from Renmin Hospital of Wuhan University between January to June 2018.A total of 103 patients with angina pectoris aged 60.20±9.35 were included as angina pectoris group.A total of 102 patients with myocardial infarction aged 58.85±9.80 were included as AMI group.A total of 130 healthy individuals aged 63.14±10.40 were included as healthy control.Spearman analysis was performed to investigate the correlations between Gas6 and risk factors of(coronary heart disease,CHD).Logistic regression was performed to investigate the risk factor of myocardial infarction.ROC(receiver operating characteristic)curve was used to analyze the diagnostic performance of Gas6 to AMI.Results The levels of Gas6 in angina pectoris group[13.77(10.57-17.03)ng/ml,t=2.444,P=0.025]and AMI group[16.22(12.70-20.09)ng/ml,t=4.965,P<0.001]was higher than control group[10.92(8.90-14.92)ng/ml].The levels of Gas6 in angina pectoris group was lower than AMI group(t=3.854,P<0.001).In the sensitivity analysis excluding hypertension and diabetes,the serum Gas6 level in AMI group(n=37)[15.05(11.08-16.20)mg/L]was higher than that in control group[10.93(8.91-14.93)mg/L,t=3.479,P=0.001]and angina group(n=42)[12.85(9.10-16.20)mg/L,t=2.639,P=0.019].CRP(C-reactive protein),WBC(white blood cell count),Glu(fasting glucose)and Cr(creatinine)were positively correlated with Gas6,r=0.194,0.176,0.180 and 0.120,P value=0.010,0.012,0.010 and 0.002,respectively.Logistic regression showed that Gas6 was a independent factor of myocardial infarction[OR and 95%CI were 1.080(1.012-1.152),P=0.020].AUC and 95%CI of ROC curve was 0.648(0.572-0.723).Conclusion The levels of Gas6 may be positively associated with myocardial infarction risk.

关 键 词：急性心肌梗死 炎症反应 生长停滞特异性蛋白6 

分 类 号：R542[医药卫生—心血管疾病]