血浆受体相互作用蛋白激酶-3水平与非ST段抬高型急性冠状动脉综合征患者近期预后的相关性研究  

Correlation of plasma receptor interacting protein kinase-3 with recent prognosis of patients with non-ST-segment elevation acute coronary syndrome

作　　者：李丹斌 马强[2] 杜美群 LI Danbin;MA Qiang;DU Meiqun(Department of Internal Medicine of Tongchuan Maternal and Child Health Hospital,Tongchuan 727007,China)

机构地区：[1]陕西省铜川市妇幼保健院内科,727007 [2]西安交通大学第一附属医院周围血管科 [3]铜川市人民医院南院内科

出　　处：《心肺血管病杂志》2020年第10期1174-1178,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：陕西省卫计委科技计划(2016D065)。

摘　　要：目的:探讨血浆受体相互作用蛋白激酶-3(RIP3)对非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者近期预后的预测价值。方法:选择2018年1月至2019年12月,在铜川市妇幼保健院住院治疗的205例NSTE-ACS患者纳入研究,包括不稳定性心绞痛(UAP)患者143例和非ST段抬高型心肌梗死(NSTEMI)患者62例。另选取60例稳定性心绞痛(SAP)患者作为SAP组,60例非冠心病患者作为对照组。采用ELISA法检测血浆RIP3水平,采用GRACE评分系统对NSTE-ACS患者进行评分。并对NSTE-ACS患者在出院后随访6个月,观察主要不良心脏事件发生情况。结果:UAP组、NSTEMI组血浆RIP3水平均高于SAP组和对照组,且NSTEMI组血浆RIP3水平高于UAP组,差异均有统计学意义(均P<0.01)。Pearson直线相关分析结果示血浆RIP3水平与GRACE评分呈正相关关系(r=0.527,P<0.001)。校正年龄、性别等参数,多元线性回归分析结果示NSTE-ACS患者血浆RIP3水平与GRACE评分相关(Beta=0.454,P<0.001)。二分类Logistic回归分析结果示血浆RIP3水平是NSTE-ACS患者近期预后的影响因素(OR=1.014,95%CI:1.001~1.028,P=0.034)。ROC曲线分析结果示血浆RIP3和GRACE评分预测出院6个月发生MACE的AUC分别为0.840(0.718,0.961)和0.890(0.827,0.953),差异无统计学意义(P>0.05)。结论:NSTE-ACS患者血浆RIP3水平显著升高,并与GRACE评分呈正相关关系,对患者近期预后具有较高的预测价值。Objective: To investigate the relationship between plasma levels of receptor interacting protein kinase-3(RIP3) and recent prognosis of patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS). Methods: 205 NSTE-ACS patients who hospitalized in our department from January 2018 to December 2019 were recruited in this study, including 143 patients with unstable angina pectoris(UAP) and 62 patients with non-ST segment elevated myocardial infarction(NSTEMI). 60 patients with stable angina pectoris(SAP) were selected as the SAP group and 60 patients without coronary heart disease as the control group. ELISA was used to detect plasma levels of RIP3. GRACE scores of patients with NSTE-ACS were calculated. Patients with NSTE-ACS were followed up for 6 months after discharge to observe the occurrence of major adverse cardiac events(MACE). Results: The levels of plasma RIP3 in both the UAP group and the NSTEMI group were higher than those in the SAP group and the control group, and the levels of plasma RIP3 in the NSTEMI group were higher than those in the UAP group, with statistically significant differences(all P<0.01). Pearson correlation analysis showed that plasma RIP3 level was significantly positively related to GRACE score(r=0.527, P<0.001). Multivariate regression analysis showed that plasma RIP3 was an independent influencing factor of GRACE score for NSTE-ACS patients(Beta=0.454, P<0.001). Binary logistics regression analysis showed that plasma RIP3 was independent influencing factor for recent prognosis in NSTE-ACS patients(OR=1.014, 95%CI:1.001-1.028, P=0.034). Based on the ROC curve, the areas under the ROC curve of plasma RIP3 and GRACE score in prediction of MACE were 0.840(0.718, 0.961) and 0.890(0.827, 0.953), with no statistically differences. Conclusions: Plasma RIP3 level was significantly increased in patients with NSTE-ACS, and was positively correlated with GRACE score, which was of high predictive value for the recent prognosis of NSTE-ACS patients.

关 键 词：非ST段抬高型急性冠状动脉综合征 受体相互作用蛋白激酶-3 GRACE评分 预后 

分 类 号：R54[医药卫生—心血管疾病]