ATP合酶C亚基在缺血性心脏病患者血清中的表达及临床意义  

Expression of F0 ATP synthase C subunit in serum of patients with ischemic heart disease and its clinical implications

作　　者：黄大伟 高子弟 林国 郭燕峰 林俊亮 陈时强 张孝兵 黄锡通 Huang Dawei;Gao Zidi;Lin Guo;Guo Yanfeng;Lin Junliang;Chen Shiqiang;Zhang Xiaobing;Huang Xitong(Department of Clinical Laboratory,the People's Hospital of Yuhuan,Taizhou 317600,Zhejiang,China;Department of Emergency,the People's Hospital of Yuhuan,Taizhou 317600,Zhejiang,China)

机构地区：[1]玉环市人民医院检验科,浙江台州317600 [2]玉环市人民医院急诊科,浙江台州317600

出　　处：《中华危重病急救医学》2021年第11期1322-1326,共5页Chinese Critical Care Medicine

基　　金：浙江省医药卫生科技计划项目(2019KY794)。

摘　　要：目的探讨ATP合酶C亚基(Csub)在缺血性心脏病(IHD)患者血清中的表达及临床意义。方法选择2019年5月至2020年12月玉环市人民医院急诊科收治的101例胸痛患者,其中急性心肌梗死(AMI)59例,不稳定型心绞痛(UAP)42例;同时选择体检中心年龄匹配的50例健康体检者作为健康对照(HC)。所有患者均于急诊抢救室药物及介入措施干预前完成抽血,用酶联免疫吸附试验(ELISA)检测血清Csub含量,分析Csub与临床特征之间的关系,同时用电化学发光法检测血中超敏心肌肌钙蛋白T(hs-cTnT)和肌酸激酶同工酶(CK-MB)含量。绘制受试者工作特征曲线(ROC曲线),评估Csub、hs-cTnT及CK-MB对IHD的早期诊断价值。结果3组受试者年龄、性别、既往史等基线资料均衡,低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、CK-MB、hs-cTnT及B型钠尿肽(BNP)差异具有统计学意义,其余生化指标差异均无统计学意义。AMI组及UAP组Csub含量均明显高于HC组〔8.96%(6.37%,11.53%)、4.27%(3.23%,6.49%)比1.56%(1.07%,2.33%),均P<0.01〕,且心肌缺血更为严重的AMI组Csub含量较UAP组进一步升高〔8.96%(6.37%,11.53%)比4.27%(3.23%,6.49%),P<0.01〕。59例AMI患者均接受了经皮冠状动脉介入治疗(PCI),根据Csub中位数将AMI患者分为高于中位数组(29例)和低于中位数组(30例),结果显示,两组冠状动脉病变支数、支架植入数量及术后用药情况差异均无统计学意义。ROC曲线分析显示,Csub对IHD的诊断效能〔曲线下面积(AUC)=0.98,95%可信区间(95%CI)为0.95~1.00〕略低于hs-cTnT(AUC=0.99,95%CI为0.99~1.00),却高于CK-MB(AUC=0.94,95%CI为0.89~0.99)。Csub最佳截断值为4.74%时,诊断IHD的敏感度为100%,特异度为87.0%。结论Csub在IHD患者血清中显著升高,且随着缺血程度的加剧进一步升高,其可作为诊断以及评估心肌缺血发展的新型诊断标志物。Objective To investigate the expression and clinical significance of F0 ATP synthase C subunit(Csub)in patients with ischemic heart disease(IHD).Methods The 101 patients with chest pain admitted to the department of emergency of the People's Hospital of Yuhuan from May 2019 to December 2020 were enrolled,including 59 patients with acute myocardial infarction(AMI)and 42 patients with unstable angina pectoris(UAP).At the same time,50 age-matched healthy subjects in the health examination center were selected as the healthy control(HC).All patients had completed blood sampling before the intervention of drugs or other intervention measures in the emergency room.The content of serum Csub was detected by enzyme linked immunosorbent assay(ELISA),and the relationship between Csub and clinical characteristics was analyzed.At the same time,the contents of hypersensitivity cardiac troponin T(hs-cTnT)and MB isoenzyme of creatine kinase(CK-MB)in blood were detected by electrochemical luminescence.The receiver operator characteristic curve(ROC curve)was drawn to evaluate the value of Csub,hs-cTnT,and CK-MB in the early diagnosis of IHD.Results The baseline data such as age,gender,and history of the three groups were balanced.There were significant differences in low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),CK-MB,hs-cTnT and B-type natriuretic peptide(BNP),but there were no significant differences in other biochemical indexes.The Csub content in the AMI group and the UAP group were significantly higher than those in the HC group[8.96%(6.37%,11.53%),4.27%(3.23%,6.49%)vs.1.56%(1.07%,2.33%),both P<0.01].Moreover,the Csub in the AMI group with more severe myocardial ischemia was higher than UAP group[8.96%(6.37%,11.53%)vs.4.27%(3.23%,6.49%),P<0.01].A total of 59 patients with AMI were treated with percutaneous coronary intervention(PCI).According to the median of Csub,AMI patients were subdivided into above-median group(29 cases)and below-median group(30 cases).The results showed that ther

关 键 词：缺血性心脏病 ATP合酶C亚基 超敏肌钙蛋白 

分 类 号：R541[医药卫生—心血管疾病]