急性冠脉综合征患者血清Sirtuin 1与冠脉病变相关  

Association of serum SIRT1 with extent of coronary artery lesion in acute coronary syndrome patients

作　　者：王放 涂祎敏 刘晓飞[1] 张虎[1] 董哲[1] 郑金刚[1] 王是知 Wang Fang;Tu Yimin;Liu Xiaofei;Zhang Hu;Dong Zhe;Zheng Jingang;Wang Shizhi(Department of Cardiology,China-Japan Friendship Hospital,Beijing 100029,China;Faculty of Science,University of British Columbia,Canada)

机构地区：[1]中日友好医院心脏科,北京100029 [2]加拿大英属哥伦比亚大学理学院

出　　处：《中华急诊医学杂志》2021年第4期473-478,共6页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金(91639110,81700411),国家临床重点专科建设项目(2020-QTL-009)。

摘　　要：目的探讨急性冠脉综合征患者血清Sirtuin 1(SIRT1)水平与冠脉病变的相关性和影响冠脉病变的因素。方法分析81例中日友好医院心脏科急性冠脉综合征住院患者的临床数据,酶联免疫吸附测定法检测外周静脉血血清SIRT1水平,血运重建前进行SYNTAX评分评估冠脉病变程度。根据SYNTAX评分中位数将患者分为高SYNTAX评分(冠脉病变重度,n=38)和低SYNTAX评分(冠脉病变轻度,n=43)两组。建立多因素线性回归模型,统计分析影响急性冠脉综合征患者SYNTAX评分的因素。结果高SYNTAX评分组患者血清SIRT1水平[379.38(490.14)ng/L vs.242.95(173.85)ng/L,P<0.001]和冠心病家族史阳性率(42.11%vs.20.93%,P=0.039)显著高于低SYNTAX评分组患者,其余临床参数两组间差异无统计学意义。血清SIRT1水平与SYNTAX评分呈显著线性正相关(R=0.452,P<0.010)。多因素线性回归分析结果提示,血清SIRT1(ln处理后)、年龄和估计肾小球滤过率是急性冠脉综合征患者SYNTAX评分(ln处理后)的独立影响因素(Adjusted R2=0.330,P<0.001)。结论本研究首次探讨血清SIRT1和急性冠脉综合征患者冠脉病变程度的相关性,临床医生应注意识别高危患者,制订合理的血运重建策略,努力改善患者预后。Objective To investigate the potential factors influencing the extent of coronary artery lesion in acute coronary syndrome(ACS)patients with an emphasis on the role of serum SIRT1.Methods We assessed the clinical data from 81 ACS patients admitted to China-Japan Friendship Hospital.Serum SIRT1 was detected by enzyme linked immunosorbent assay(ELISA),and the extent of coronary artery lesion was evaluated by SYNTAX score before revascularization.All the patients were divided into two groups:high SYNTAX score(severe coronary artery lesion,n=38)and low SYNTAX score(moderate coronary artery lesion,n=43),by means of the median of SYNTAX score.Potential factors influencing SYNTAX score were analyzed through multiple linear regression analysis.Results Compared with the low SYNTAX score group,patients in the high SYNTAX score group had higher serum SIRT1 level[379.38(490.14)ng/L vs.242.95(173.85)ng/L,P<0.001]and frequency of coronary artery disease family history(42.11%vs.20.93%,P=0.039).There was no statistical difference among other factors between the two groups.Serum SIRT1 was positively correlated with SYNTAX score in ACS patients(R=0.452,P<0.010).Serum SIRT1(ln adjusted),age and estimated glomerular filtration rate were independently correlated with SYNTAX score(ln adjusted)in multiple linear regression analysis(Adjusted R2=0.330,P<0.001).Conclusions For the first time,we discussed the correlation of serum SIRT1 with extent of coronary artery lesion in ACS patients.Cardiologists should pay more attention to high-risk patients in order to improve the prognosis of ACS patients through timely revascularization strategies.

关 键 词：急性冠脉综合征 急性ST段抬高型心肌梗死 急性非ST段抬高型心肌梗死 不稳定型心绞痛 血清SIRT1 冠脉病变程度 SYNTAX评分 多因素线性回归分析 

分 类 号：R541.4[医药卫生—心血管疾病]