血清netrin-4、vitronectin与急性冠状动脉综合征患者PCI术预后的相关性  

Associations between serum netrin-4 and vitronectin,and prognosis in patients with acute coronary syndrome after PCI

作　　者：刘志云 颜永进 丁宏胜 LIU Zhiyun;YAN Yongjin;DING Hongsheng(Department of Cardiology,Hai'an people's Hospital,Hai'an Jiangsu 226600,China)

机构地区：[1]海安市人民医院心血管内科,江苏海安226600

出　　处：《转化医学杂志》2022年第4期210-213,共4页Translational Medicine Journal

摘　　要：目的探讨血清netrin-4、玻连蛋白(vitronectin,VTN)与急性冠状动脉综合征(acute coronary syndrome,ACS)患者经皮冠状动脉介入术(percutaneous coronary intervention,PCI)预后的相关性。方法选取2019年9月至2021年9月在海安市人民医院行PCI治疗的114例ACS患者作为研究对象。连续随访6个月后,根据有无发生主要不良心血管事件(major adverse cardiovascular events,MACE)分为良好组(79例)和不良组(35例)。采用酶联免疫吸附法检测两组患者血清netrin-4、VTN水平。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)评价血清netrin-4、VTN对ACS患者PCI术预后的预测价值,采用多因素logistic回归分析影响ACS患者PCI术预后的危险因素。结果良好组的三酰甘油(triacylglycerol,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白-胆固醇(low density lipoprotein,LDL-C)、Gensini评分低于不良组,高密度脂蛋白胆固醇(high density lipoprotein choles-terol,HDL-C)、左心室射血分数(left ventricular ejection fraction,LVEF)高于不良组(P<0.05)。良好组的血清netrin-4、VTN水平低于不良组(P<0.05)。血清netrin-4、VTN预测ACS患者PCI术预后的ROC曲线下面积(Area Under Curve,AUC)(95%CI)分别为0.766(0.715~0.814)、0.831(0.782~0.886),截点值分别为90.45 ng/mL、91.07μg/mL,特异度分别为50.63%、91.43%,灵敏度分别为68.35%、91.43%,两者联合诊断的AUC(95%CI)为0.923(0.871~0.973),特异度为84.81%,灵敏度为85.71%。多因素logistic回归分析结果显示,高脂血症、Gensini评分≥50分、netrin-4≥90.45 ng/mL、VTN≥91.07μg/mL均是ACS患者PCI术预后不良的危险因素(P<0.05)。结论血清netrin-4、VTN有望作为预测ACS患者PCI术预后不良的生物学指标,且血清netrin-4、VTN水平升高是患者预后不良的危险因素。Objective To explore the associations between serum netrin-4 and vitronectin(VTN),and prognosis in patients with acute coronary syndrome(ACS)ater percutaneous coronary intervention(PCI).Methods A total of 114 ACS patients who underwent PCI in our hospital from September 2019 to September 2021 were selected as the re-search subjects.After 6 months of continuous follow-up,they were divided into a good group(79 cases)and a poor group(35 cases)according to the occurrence of adverse cardiovascular events(MACE).Serum levels of netrin-4 and VTN were detected by enzyme-linked immunosorbent assay.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum netrin-4 and VTN on the prognosis of ACS patients after PCI,and multivariate lo-gistic regression was used to analyze the risk factors affecting the prognosis of ACS patients after PCI.Results The TG,TC,LDL-C and Gensini scores of the good group were lower than those of the poor group,and HDL-C and LVEF were higher than those of the poor group(P<0.05).The serum netrin-4 and VTN levels in the good group were lower than those in the poor group(P<0.05).The AUC(95%CI)of serum netrin-4 and VTN in predicting the prognosis of ACS patients after PCI were 0.766(0.715-0.814)and 0.831(0.782-0.886),respectively,and the cut-off values were 90.45ng/mL and 91.07μg/mL,respectively.The specificity was 50.63%and 91.43%,and the sensitivity was 68.35%and 91.43%,respectively.The AUC(95%CI)of the combined diagnosis was 0.923(0.871-0.973),and the specificity was 84.81%,and the sensitivity was 85.71%.The results of multivariate logistic regression analysis showed that hyperlipidemia,Gensini score≥50 scores,netrin-4≥90.45ng/mL and VTN≥91.07μg/mL were all risk factors for poor prognosis of ACS patients after PCI(P<0.05).Conclusions Serum netrin-4 and VTN are expected to be used as biological indicators to predict the poor prognosis of ACS patients after PCI,and elevated serum netrin-4 and VTN levels are risk factors for poor prog-nosis of patients.

关 键 词：netrin-4 玻连蛋白 急性冠状动脉综合征 经皮冠状动脉介入术 预后 

分 类 号：R541.4[医药卫生—心血管疾病]