急性冠脉综合征患者外周血前蛋白转化酶枯草溶菌素9水平及其对患者预后的预测价值  

Peripheral blood level of proprotein convertase subtilisin/kexin type 9 and its predictive value for prognosis in patients with acute coronary syndrome

作　　者：谈礼武[1] 阳维德[1] 王新云[1] 张红雨[1] TAN Li-wu;YANG Wei-de;WANG Xin-yun;ZHANG Hong-yu(Department of Cardiovascular Medicine,Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin 541002,China)

机构地区：[1]广西壮族自治区南溪山医院心血管内科,桂林市541002

出　　处：《广西医学》2020年第15期1954-1958,共5页Guangxi Medical Journal

摘　　要：目的探讨急性冠脉综合征(ACS)患者外周血前蛋白转化酶溶菌素9(PCSK9)水平及其对患者预后的预测价值。方法选择88例ACS患者(ACS组)和76例健康个体(健康组),比较两组治疗前的PCSK9、N端脑钠肽前体(NT-proBNP)与超敏C反应蛋白(hs-CRP)水平的差异。根据Gensini积分将ACS患者分为预后良好组(n=60)和预后不良组(n=28),比较两组治疗前及治疗后1 d、3 d、5 d的PCSK9、NT-proBNP、hs-CRP水平。采用受试者工作特征曲线评价治疗后5 d的PCSK9、NT-proBNP、hs-CRP水平对ACS患者预后的预测价值。结果ACS组治疗前的PCSK9、NT-proBNP、hs-CRP水平均高于健康组(均P<0.05)。与预后良好组比较,预后不良组各个时间点的PCSK9、NT-proBNP水平,以及治疗前、治疗后3 d、5 d的hs-CRP水平均更高(均P<0.05)。治疗后5 d PCSK9水平预测ACS预后的曲线下面积为0.941,灵敏度、特异度分别为89.40%、93.30%,均高于同一时点的其他两个指标。结论与健康人群比较,ACS患者外周血PCSK9水平明显上调,动态监测PCSK9水平有助于预测患者治疗后的预后情况。Objective To explore peripheral blood level of proprotein convertase subtilisin/kexin type 9(PCSK9)and its predictive value for prognosis among patients with acute coronary syndrome(ACS).Methods Eighty-eight patients with ACS(ACS group)and 76 healthy individuals(healthy group)were enrolled,and differences in PCSK9,N-terminal pro-brain natriuretic peptide(NT-proBNP)and high-sensitivity C-reactive protein(hs-CRP)levels before treatment were compared between the two groups.ACS patients were divided into good prognosis group(n=60)and poor prognosis group(n=28)according to Gensini score,the levels of PCSK9,NT-proBNP and hs-CRP were compared between the two groups before treatment and one,three and five days after treatment.Receiver operating characteristic(ROC)curve was used to evaluate the value of PCSK9,NT-proBNP,and hs-CRP levels at five days after treatment in predicting the prognosis of ACS patients.Results The levels of PCSK9,NT-proBNP and hs-CRP before treatment in the ACS group were higher than those in the healthy group(all P<0.05).Compared with the good prognosis group,the poor prognosis group had higher PCSK9 and NT-proBNP levels at all time points,as well as higher hs-CRP levels before treatment and three and five days after treatment(all P<0.05).Five days after treatment,PCSK9 level had the area under the curve for predicting the prognosis of ACS of 0.941,with a sensitivity of 89.40% and a specificity of 93.30%,higher than the other two indicators at same time point.Conclusion Compared with healthy population,patients with ACS experience notably up-regulated peripheral blood PCSK9 level,and dynamic monitoring of PCSK9 level is helpful to predict the prognosis of patients after treatment.

关 键 词：急性冠脉综合征 前蛋白转化酶枯草溶菌素9 预后 预测价值 

分 类 号：R543.3[医药卫生—心血管疾病]