急性ST段抬高型心肌梗死患者血清HPSE和SCUBE1水平与血栓负荷的关系研究  

Study the relationship between serum heparinase,signal peptide-CUB-epidermal growth factor domain containing protein 1and thrombus load in patients with acute ST-segment elevation myocardial infarction

作　　者：师艳莉 田洪森[1] 孙江江[1] 沈玉珏[1] 赵瑞翡 SHI Yanli;TIAN Hongsen;SUN Jiangjiang;SHEN Yujue;ZHAO Ruifei(Second Department of Cardiology,Handan Central Hospital,Handan,Hebei,056000,China)

机构地区：[1]邯郸市中心医院心内二科,河北邯郸056000

出　　处：《临床急诊杂志》2021年第12期851-855,共5页Journal of Clinical Emergency

基　　金：河北省2019年度医学科学研究课题计划(No:20191855)。

摘　　要：目的:研究急性ST段抬高型心肌梗死(ASTEMI)患者血清乙酰肝素酶(HPSE)、信号肽-CUB-表皮生长因子结构域包含蛋白1(SCUBE1)水平与血栓负荷的关系。方法:纳入我院于2019年11月—2020年12月期间收治的118例ASTEMI患者作为研究对象,将其按照冠状动脉造影明确的血栓负荷程度差异分作低血栓负荷组(72例)以及高血栓负荷组(46例)。检测并比较两组血清HPSE以及SCUBE1水平,通过单因素及多因素Logistic回归分析ASTEMI患者高血栓负荷的相关影响因素。此外,采用受试者工作特征(ROC)曲线分析血清HPSE以及SCUBE1预测ASTEMI患者高血栓负荷的效能。结果:高血栓负荷组血清HPSE以及SCUBE1水平均高于低血栓负荷组(P<0.05)。经多因素Logistic回归分析发现:血清HPSE、SCUBE1、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)水平均是ASTEMI患者高血栓负荷的危险因素,而术后冠脉心肌梗死溶栓试验(TIMI)分级为Ⅲ级是保护性因素(均P<0.05)。经ROC曲线结果显示:血清HPSE以及SCUBE1联合检测预测ASTEMI患者高血栓负荷的曲线下面积、敏感度、特异度及约登指数均明显高于上述指标单独预测。结论:ASTEMI患者血清HPSE以及SCUBE1均和血栓负荷密切相关,联合检测具有预测ASTEMI患者高血栓负荷的价值。Objective:To study the relationship between serum heparanase(HPSE),signal peptide-CUB-epidermal growth factor domain containing protein 1(SCUBE1)and thrombotic load in patients with acute ST-segment elevation myocardial infarction(ASTEMI).Methods:A total of 118patients with ASTEMI who were admitted to our hospital from November 2019to December 2020were included as the study subjects,and they were divided into low thrombotic load group with 72cases and high thrombotic load group with 46cases according to the difference in degree of thrombotic load determined by coronary angiography.Serum HPSE and SCUBE1levels were detected and compared between the two groups.Univariate and multivariate Logistic regression was used to analyze the related factors of high thrombus load in patients with ASTEMI.In addition,receiver operating characteristic(ROC)curves were used to analyze the efficacy of serum HPSE and SCUBE1in predicting high thrombotic load in patients with ASTEMI.Results:The serum HPSE and SCUBE1levels in high thrombus load group were higher than those in low thrombus load group(P<0.05).Multivariate logistic regression analysis showed that serum HPSE,SCUBE1,creatine kinase-MB(CK-MB)and cardiac troponin I(cTnI)levels were all risk factors for high thrombus load in patients with ASTEMI,while postoperative coronary Thrombolysis in myocardial infarction(TIMI)gradeⅢwas a protective factor(all P<0.05).The ROC curve results showed that the area under the curve,sensitivity,specificity and Yorden index of serum HPSE and SCUBE1combined detection for predicting high thrombotic load in patients with ASTEMI were significantly higher than those predicted by the above indexes alone.Conclusion:Serum HPSE and SCUBE1are closely related to thrombotic load in patients with ASTEMI,and combined detection has the value of predicting high thrombotic load in patients with ASTEMI.

关 键 词：急性ST段抬高型心肌梗死 乙酰肝素酶 信号肽-CUB-表皮生长因子结构域包含蛋白1 血栓负荷 危险因素 

分 类 号：R542.2[医药卫生—心血管疾病]