急性冠脉综合征病人PCI术后血清半乳糖凝集素-3、IGF-1表达及其与短期预后的相关性分析  

Expression of Serum Galectin-3 and IGF-1 in Patients with Acute Coronary Syndrome after PCI and Their Correlation with Short-term Prognosis

作　　者：缪志静 关敬树 周云 施珊岚 张超 危蕾 MIAO Zhijing;GUAN Jingshu;ZHOU Yun;SHI Shanlan;ZHANG Chao;WEI Lei(Shanghai Baoshan Integrated Traditional Chinese and Western Medicine Hospital,Shanghai 201999,China)

机构地区：[1]上海市宝山中西医结合医院,上海201999

出　　处：《中西医结合心脑血管病杂志》2022年第16期2899-2903,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：上海市科委医学引导类(中、西医)科技支撑项目(No.19401933200)。

摘　　要：目的观察急性冠脉综合征(ACS)病人经皮冠状动脉介入(PCI)术后血清半乳糖凝集素-3、胰岛素样生长因子-1(IGF-1)的表达及其与短期预后的相关性。方法选取2018年1月—2019年6月在我院心内科住院且行PCI术治疗的ACS病人102例,根据病人短期预后情况分为研究组(发生MACE,28例)和对照组(未发生MACE,74例)。比较两组临床资料,采用全自动生化仪检测总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平;采用酶联免疫吸附法检测ACS病人PCI术后血清半乳糖凝集素-3、IGF-1水平;采用受试者工作特征(ROC)曲线评价血清半乳糖凝集素-3、IGF-1水平对ACS病人发生MACE的诊断价值;采用多因素Logistic回归分析影响ACS病人预后不良的危险因素。结果研究组左室射血分数低于对照组(P<0.05);入院后不同时间,研究组血清半乳糖凝集素-3水平均高于对照组(P<0.05),IGF-1水平均低于对照组(P<0.05);研究组入院时血清半乳糖凝集素-3水平最高,IGF-1水平最低,随着时间增加,半乳糖凝集素-3水平逐渐降低,IGF-1水平逐渐升高。ROC结果显示,PCI术后第3天血清半乳糖凝集素-3诊断ACS病人MACE发生的ROC曲线下面积(AUC)为0.858[95%CI(0.775,0.919)],IGF-1诊断MACE发生的AUC为0.762[95%CI(0.667,0.840)],半乳糖凝集素-3联合IGF-1诊断MACE发生的AUC为0.889[95%CI(0.812,0.943)],灵敏度为71.43%,特异度为94.34%。多因素Logistic回归分析结果显示,PCI术后第3天半乳糖凝集素-3>7.22 ng/mL、IGF-1≤110.81 ng/mL是影响ACS病人PCI术后短期预后不良的危险因素(P<0.05)。结论ACS病人PCI术后血清半乳糖凝集素-3水平升高,IGF-1水平降低,是短期预后不良的独立危险因素。Objective To observe the expressions of serum galectin-3 and insulin-like growth factor-1(IGF-1)in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI)and their correlation with short-term prognosis.Methods A total of 102 ACS patients were selected.According to the short-term prognosis of the patients,they were divided into the study group[with major adverse cardiovascular events(MACE),28 cases]and the control group(without MACE,74 cases),The clinical data of two groups were compared,and the levels of total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)were detected by automatic biochemical analyzer.The levels of serum galectin-3 and IGF-1 in ACS patients after PCI were tested by linked immunosorbent assay(ELISA).Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum galectin-3 and IGF-1 levels for MACE in ACS patients.Multivariate Logistic regression was used to analyze the risk factors for poor prognosis of ACS patients.Results The left ventricular ejection fraction in the study group was lower than that in the control group(P<0.05);at different times after admission,the level of serum galectin-3 in the study group was higher than that in the control group(P<0.05),and the level of IGF-1 was lower than that in the control group(P<0.05).The level of serum galectin-3 in the study group was the highest and the level of IGF-1 was the lowest at admission,the level of galectin-3 gradually was decreased and the level of IGF-1 was increased gradually with time.The ROC results showed that the areas under the ROC curve(AUC)of serum galectin-3 and IGF-1 for the diagnosis of MACE in ACS patients at the 3rd day after PCI were 0.858[95%CI(0.775,0.919)],0.762[95%CI(0.667,0.840)],the AUC of galectin-3 combined with IGF-1 in the diagnosis of MACE was 0.889[95%CI(0.812,0.943)],and the sensitivity was 71.43%and specificity was 94.34%.The results of multivariate Logistic regressi

关 键 词：急性冠脉综合征 经皮冠状动脉介入 半乳糖凝集素-3 胰岛素样生长因子-1 短期预后 

分 类 号：R541.4[医药卫生—心血管疾病]