血清FABP4、Cat S和PON-1在急性非ST段抬高心肌梗死中的临床价值  

Clinical value of serum FABP4,Cat S and PON-1 in acute non-ST-elevation myocardial infarction

作　　者：陆霞琴 LU Xiaqin(Department of Emergency,Eastern Hospital of Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院东院急诊科,上海201203

出　　处：《检验医学与临床》2021年第18期2691-2694,2699,共5页Laboratory Medicine and Clinic

摘　　要：目的观察血清脂肪酸结合蛋白-4(FABP4)、组织蛋白酶S(Cat S)和氧磷酶(PON)-1预测急性非ST段抬高心肌梗死(NSTEMI)患者发生主要不良心血管事件(MACE)的临床价值。方法选择2019年该院收治的119例NSTEMI患者作为NSTEMI组。另选同期于该院就诊的45例ST段抬高心肌梗死(STEMI)和75例不稳定型心绞痛(UAP)患者分别作为STEMI组、UAP组。比较各组血清FABP4、Cat S和PON-1水平的变化,分析NSTEMI患者血清FABP4、Cat S和PON-1水平与MACE发生的危险程度和心功能的关系,评估其对NSTEMI发生MACE的预测效能。结果STEMI组血清FABP4和Cat S水平高于NSTEMI组和UAP组,NSTEMI组高于UAP组,且随着MACE发生的危险程度和心功能分级升高而升高(P<0.05);而STEMI组血清PON-1水平低于NSTEMI组和UAP组,NSTEMI组低于UAP组,且随着MACE发生的危险程度和心功能分级升高而降低(P<0.05)。MACE组血清FABP4和Cat S水平高于非MACE组,而血清PON-1水平低于非MACE组(P<0.05)。血清FABP4、Cat S和PON-1对NSTEMI患者发生MACE均有较高的预测效能,3项联合检测的曲线下面积(AUC)为0.983,高于FABP4、Cat S和PON-1的AUC(P<0.05)。结论血清FABP4、Cat S和PON-1在NSTEMI患者中出现异常表达,3项指标联合检测对NSTEMI患者发生MACE具有重要的预测价值。Objective To observe the clinical value of serum fatty acid binding protein-4(FABP4),cathepsin S(Cat S)and paraoxonase(PON)-1 in prediction of major adverse cardiovascular events(MACE)in patients with acute non-ST-elevation myocardial infarction(NSTEMI).Methods A total of 119 patients with NSTEMI in the hospital in 2019 were selected as the NSTEMI group.In addition,45 patients with ST-elevation myocardial infarction(STEMI)and 75 patients with unstable angina(UAP)who visited the hospital during the same period were selected as STEMI group and UAP group,respectively.The changes of serum FABP4,Cat S and PON-1 levels in each group were compared,and the relationship between serum FABP4,Cat S and PON-1 levels in patients with NSTEMI and the risk of MACE and cardiac function were analyzed,and the prediction efficacy of MACE in NSTEMI was evaluated.Results The levels of serum FABP4 and Cat S in STEMI group were higher than NSTEMI group and UAP group,and those in NSTEMI group were higher than those in UAP group,and increased with the risk of MACE and the grade of cardiac function(P<0.05);While the level of serum PON-1 in STEMI group was lower than that in NSTEMI group and UAP group,and that in NSTEMI group was lower than that in UAP group,and decreased with the increase of MACE risk and cardiac function grade(P<0.05).The levels of serum FABP4 and Cat S in MACE group were higher than those in non MACE group,while the level of serum PON-1 was lower than that in non MACE group(P<0.05).Serum FABP4,Cat S and PON-1 had high predictive efficacy for Mace in NSTEMI patients.The area under the curve of the three combined tests was 0.983,which was higher than that of FABP4,Cat S and PON-1(P<0.05).Conclusion Serum FABP4,Cat S and PON-1 are abnormally expressed in patients with NSTEMI.The combined detection of the three indicators has important predictive value for MACE in patients with NSTEMI.

关 键 词：急性心肌梗死 脂肪酸结合蛋白-4 组织蛋白酶S 氧磷酶-1 主要不良心血管事件 

分 类 号：R446.11[医药卫生—诊断学] R541.4[医药卫生—临床医学]