急性冠脉综合征患者血浆sLRP-1、血清RANTES与GRACE评分的相关性分析  

Correlation of plasma sLRP-1,serum RANTES and GRACE score in patients with acute coronary syndrome

作　　者：田雅楠[1] 胡娜[2] 宋海玖 秦巍 丁振江[1] TIAN Ya-nan;HU Na;SONG Hai-jiu;QIN Wei;DING Zhen-jiang(Department of Cardiology,Affiliated Hospital of Chengde Medical University,Chengde,Hebei 067000,China;不详)

机构地区：[1]承德医学院附属医院心脏内科,河北承德067000 [2]承德医学院附属医院南区心脏内科,河北承德067000 [3]承德市中医院内一科,河北承德067000

出　　处：《中国临床研究》2020年第7期904-907,共4页Chinese Journal of Clinical Research

基　　金：河北省政府资助专科带头人培养项目(361008);承德市科学技术与发展计划项目(201801A055)。

摘　　要：目的探讨急性冠脉综合征(ACS)患者血浆可溶性低密度脂蛋白受体相关蛋白1(sLRP-1)、血清调节活化正常T细胞表达和分泌因子(RANTES)与全球急性冠状动脉事件注册(GRACE)评分的关系,进一步分析其对30 d内发生主要不良心血管事件(MACE)的预测价值。方法选取2018年6月至11月收治的ACS患者120例,ELISA法测血浆sLRP-1和血清RANTES水平,记录GRACE评分及危险分层(>140分为GRACE高危组,109~140分为中危组,<109分为低危组)。sLRP-1(μg/ml)水平呈偏态分布,取lg转换后呈正态分布,以lg sLRP-1(μg/ml)进行统计分析。根据lg sLRP-1、RANTES中位数值分别分为高lg sLRP-1组(>0.54μg/ml)和低lg sLRP-1组(≤0.54μg/ml)、高RANTES组(>125.47 pg/ml)和低RANTES组(≤125.47 pg/ml)。分析sLRP-1、RANTES水平与GRACE评分的关系及对预后的评估。结果GRACE评分高危组lg sLRP-1、RANTES水平分别高于中危组和低危组(P均<0.05)。高lg sLRP-1组、高RANTES组GRACE评分分别高于低lg sLRP-1组、低RANTES组(P均<0.01)。ACS患者血浆lg sLRP-1、血清RANTES水平与GRACE评分呈正相关(r=0.460,P<0.05;r=0.626,P<0.05)。对于ACS 30 d发生MACE的患者,lg sLRP-1、RANTES、GRACE评分以及三者联合预测的ROC曲线下面积分别为0.875、0.787、0.820和0.924,以三者联合为高(P<0.05)。结论sLRP-1、RANTES水平与ACS相关,sLRP-1、RANTES联合GRACE评分能更好地反映ACS患者的危险分层。Objective To investigate the relationship between plasma soluble low-density lipoprotein receptor-related protein-1(sLRP-1),serum regulated upon activation normal T cell expressed and secreted(RANTES)and Global Registry of Acute Coronary Events(GRACE)score in the patients with acute coronary syndrome(ACS)and further analyze their impacts on 30 d major adverse cardiac event(MACE).Methods A total of 120 ACS patients were selected,in whom plasma sLRP-1 and serum RANTES levels were detected by ELISA.Based on the risk assessment and stratification of GRACE scores,the patients were divided into high-risk group(GRACE score>140),medium-risk group(109-140)and low-risk group(<109).The statistical analysis was carried out with lg sLRP-1(μg/ml)in a normal distribution after lg conversion.According to the median value of lg sLRP-1 and RANTES,the patients were divided into high lg sLRP-1 group(>0.54μg/ml),low lg sLRP-1 group(≤0.54μg/ml),and high RANTES group(>125.47 pg/ml),low RANTES group(≤125.47 pg/ml),respectively.The associations of sLRP-1 and RANTES levels with GRACE scores and prognosis were analyzed and evaluated.Results The levels of lg sLRP-1 and RANTES were significantly elevated in high-risk group compared with those in medium-risk group and low-risk group(all P<0.05).GRACE scores in high lg sLRP-1 group and high RANTES group were statistically higher than those in low lg sLRP-1 group and low RANTES group,respectively(all P<0.01).GRACE score was positively correlated with lg sLRP-1 and RANTES levels,respectively(r=0.460,P<0.05;r=0.626,P<0.05).In terms of lg sLRP-1,RANTES,GRACE score and the combination of the three predicting 30 d MACE,the area under the ROC curve(AUC)were 0.875,0.787,0.820 and 0.924,respectively,and AUC of the combination of three was the highest(P<0.05).Conclusions The sLRP-1 and RANTES are associated with the progress of ACS.Detection of sLRP-1 and RANTES combined with GRACE scores can better reflect the risk stratification of ACS patients.

关 键 词：可溶性低密度脂蛋白受体相关蛋白1 调节活化正常T细胞表达和分泌因子 全球急性冠状动脉事件注册评分 急性冠脉综合征 预后 

分 类 号：R541.4[医药卫生—心血管疾病]