sST2对ACS早期危险分层及不良心血管事件预测价值的Meta分析  

The Predictive Value of sST2 on Early Risk Stratification and Adverse Cardiovascular Events of ACS:a Meta-analysis

作　　者：冯娟 闫奎坡[1,2] 朱翠玲[1,2] 孙彦琴[1,2] 郭雨晴 徐亚洲[2] 刘刚[2] FENG Juan;YAN Kuipo;ZHU Cuiling;SUN Yanqin;GUO Yuqing;XU Yazhou;LIU Gang(Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学,郑州450000 [2]河南中医药大学第一附属医院,郑州450000

出　　处：《中西医结合心脑血管病杂志》2022年第18期3279-3285,共7页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金青年基金支持项目(No.81303073);河南中医学院省属科研业务专项(No.2014KYYWF-YQ12);河南省科技攻关重点项目(No.112102310317);河南省高校科技创新团队支持计划(No.13IRTSTHN012);河南省中医药防治心血管疾病创新型科技团队项目(No.C20130050);人社部留学人员资助项目,编号:人社函[2010]412号;河南省首批青苗人才培养项目,编号:豫中医科教[2018]16号;河南省科技攻关项目(No.192102310161,182102310291);河南省中医药科学研究专项课题(No.2017ZY2017)。

摘　　要：目的 系统评价可溶性致癌抑制因子2(sST2)在急性冠脉综合征(ACS)早期危险分层和不良心血管事件中的预测价值,为ACS的早期诊断、疾病危险分层和不良心血管事件(MACE)的评估提供借鉴。方法 检索PubMed、the Cochrane Library、中国知网(CNKI)、万方(WanFang Data)、维普(VIP)、中国生物医学文献数据库(CBM)等数据库建库至2020年12月已发表的sST2与ACS相关文献,两名研究者独立筛选文献、提取资料后,采用RevMan 5.3软件进行Meta分析。结果 共纳入12篇文献。Meta分析结果显示,不稳定型心绞痛(UA)组、非ST段抬高型心肌梗死(NSTEMI)组、ST段抬高型心肌梗死(STEMI)组、急性心肌梗死(AMI)组病人sST2水平均高于对照组[MD=20.81,95%CI(16.75,24.88)];ACS组内亚组间分析显示,NSTEMI组[MD=17.18,95%CI(4.08,30.28)]、STEMI组[MD=38.56,95%CI(9.94,67.18)]、AMI组[MD=9.39,95%CI(3.92,14.86)]sST2水平明显高于UA组,STEMI组sST2水平高于NSTEMI组[MD=17.61,95%CI(0.89,34.34)],随访期间发生不良心血管事件组sST2水平高于未发生不良心血管事件组[SMD=2.42,95%CI(1.22,3.61)]。结论 sST2可作为预测ACS的生物标志物,对ACS病人的早期诊断、疾病危险分层和不良心血管事件的预测具有一定的参考价值,可进一步指导ACS的临床诊断与治疗。Objective To review the predictive value of serum soluble tumorigenic inhibitor-2(sST2) on early risk stratification and adverse cardiovascular events of acute coronary syndrome(ACS).Methods PubMed, the Cochrane Library, CNKI,WanFang Data, VIP,and CBM databases were searched for literatures related to sST2 and ACS from the establishment of the database to December 2020.Two reviewers independently screened literature and extracted data.Meta-analysis was performed by RevMan 5.3 software.Results Twelve articles were included.Meta analysis showed that the level of sST2 was higher in unstable angina(UA),non-ST elevation myocardial infarction(NSTEMI),ST-elevation myocardial infarction(STEMI),and acute myocardial infarction(AMI) groups than those in control group[MD=20.81,95%CI(16.75,24.88)].Compared with UA group, the levels of sST2 was higher in NSTEMI group[MD=17.18,95%CI(4.08,30.28)],STEMI group[MD=38.56,95%CI(9.94,67.18)],and AMI group[MD=9.39,95%CI(3.92,14.86)].The level of sST2 was higher in STEMI group than that in NSTEMI group[MD=17.61,95%CI(0.89,34.34)].The level of sST2 was higher in MACE group than that in non-MACE group during follow-up[SMD=2.42,95%CI(1.22,3.61)].Conclusion sST2 can be used as a biomarker to predict for early diagnosis, disease risk stratification, and prediction of adverse cardiovascular events in ACS patients, and it can further guide the clinical diagnosis and treatment of ACS.

关 键 词：急性冠脉综合征 可溶性致癌抑制因子2 早期危险分层 不良心血管事件 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]