MMP-10、Hcy对非ST段抬高型急性冠状动脉综合征的诊断效能及其与疾病发生、严重程度的相关性研究  

Diagnostic Efficacy of MMP-10 and Hcy in Non-ST-segment Elevation Acute Coronary Syndrome and Their Correlation with Disease Development and Severity

作　　者：王海卓 丁荣伟 WANG Hai-zhuo;DING Rong-wei(Department of Cardiology and Nephrology,Hospital of PLA 82 Army Group,Baoding,Hebei 071000,China;the Third Department of Internal Medicine,Baoding Hengxing Integrated Traditional Chinese and Western Medicine Hospital,Baoding,Hebei 071000,China)

机构地区：[1]中国人民解放军陆军第八十二集团军医院心肾内科心脏病区,河北保定071000 [2]保定恒兴中西医结合医院内三科,河北保定071000

出　　处：《临床误诊误治》2020年第10期62-66,共5页Clinical Misdiagnosis & Mistherapy

基　　金：天津市科技计划面上项目(201504154)。

摘　　要：目的探讨血清基质金属蛋白酶-10(MMP-10)、同型半胱氨酸(Hcy)对非ST段抬高型急性冠状动脉综合征(non-ST-segment elevation acute coronary syndrome,NSTE-ACS)的诊断效能及其与疾病发生、严重程度的相关性。方法选取我院2017年8月-2019年8月收治的NSTE-ACS患者200例作为NSTE-ACS组,采用受试者工作特征(receiver operating characteristic,ROC)曲线及DeLong非参数检验,分析比较MMP-10、Hcy单独及联合检测诊断NSTE-ACS的效能;采用Pearson线性回归分析,研究MMP-10、Hcy水平与NSTE-ACS患者Syntax评分的相关性。另选同期经冠状动脉造影检查证实的冠心病患者118例作为对照组,收集两组临床资料,采用多因素Logistic回归模型分析NSTE-ACS发生的影响因素。结果MMP-10、Hcy联合检测NSTE-ACS的诊断效能显著优于两个指标单独检测(Z=2.641,P=0.008;Z=2.265,P=0.025)。Pearson相关分析结果显示,血清MMP-10、Hcy水平与NSTE-ACS患者Syntax评分均呈正相关(r=0.571,P<0.001;r=0.553,P<0.001)。多因素Logistic回归分析结果显示:2型糖尿病史、高血压病史、MMP-10≥6.25μg/L、Hcy≥15.88μmol/L是NSTE-ACS发生的独立危险因素(P<0.05或P<0.01)。结论血清MMP-10、Hcy联合诊断NSTE-ACS的效能最佳,并与患者冠状动脉病变严重程度呈正相关;血清MMP-10≥6.25μg/L、Hcy≥15.88μmol/L是NSTE-ACS发生的独立危险因素,可作为临床早期辅助诊断指标。Objective To investigate the diagnostic efficacy of serum matrix metalloproteinase-10(MMP-10)and homocysteine(Hcy)in patients with non-ST segment elevation acute coronary syndrome(NSTE-ACS),their correlation with disease development and severity.Methods A total of 200 patients with NSTE-ACS admitted to our hospital were selected as the NSTE-ACS group,and the receiver operating characteristic(ROC)curve and Delong nonparametric test were used to analyze and compare the efficacy of MMP-10 and Hcy in the diagnosis of NSTE-ACS.Pearson linear regression analysis was used to study the correlation between MMP-10,Hcy levels and Syntax score of NSTE-ACS patients.Another 118 patients with non coronary heart disease confirmed by coronary angiography were selected as the control group.The clinical data of the two groups were collected.The influencing factors of NSTE-ACS were analyzed by multivariate logistic regression model.Results The diagnostic efficiency of combined detection of MMP-10 and Hcy in NSTE-ACS was significantly better than that of single detection(Z=2.641,P=0.008;Z=2.265,P=0.025).Pearson correlation analysis showed that serum MMP-10 and Hcy levels were positively correlated with Syntax score of NSTE-ACS patients(r=0.571,P<0.001;r=0.553,P<0.001).Multivariate logistic regression analysis showed that type 2 diabetes,hypertension,MMP-10≥6.25μg/L,Hcy≥15.88μmol/L were independent risk factors of NSTE-ACS(P<0.05 or P<0.01).Conclusion The combination of serum MMP-10 and Hcy is the optimal in the diagnosis of NSTE-ACS,and it is positively correlated with the severity of coronary artery disease.Serum MMP-10≥6.25μg/L and Hcy≥15.88μmol/L are independent risk factors of NSTE-ACS,which can be used as indicators for early diagnosis in clinical practice.

关 键 词：急性冠状动脉综合征 基质金属蛋白酶-10 同型半胱氨酸 诊断效能 

分 类 号：R542.2[医药卫生—心血管疾病]