急性冠脉综合征患者血清HMGB1、LP-PLA2、IMA的表达水平及其与预后的关系  

Expression of serum HMGB1,LP-PLA2,and IMA in patients with acute coronary syndrome and their relationship with prognosis

作　　者：孟洁[1] 苏立贞 晋婕 MENG Jie;SU Li-zhen;JIN Jie(Department of Blood Transfusion,Xi'an High-tech Hospital,Xi’an 710075,Shaanxi,CHINA;Reproductive Medicine Department,Xi'an High-tech Hospital,Xi’an 710075,Shaanxi,CHINA;Xi'an Jinyu Medical Laboratory Co.Ltd,Xi’an 710018,Shaanxi,CHINA)

机构地区：[1]西安高新医院输血科,陕西西安710075 [2]西安高新医院生殖医学科,陕西西安710075 [3]西安金域医学检验所有限公司,陕西西安710018

出　　处：《海南医学》2023年第11期1560-1564,共5页Hainan Medical Journal

摘　　要：目的探讨急性冠脉综合征(ACS)患者的血清高迁移率蛋白1(HMGB1)、脂蛋白相关磷脂酶A2(LP-PLA2)、缺血修饰蛋白(IMA)的表达水平及其与预后的相关性。方法选取2020年1~12月期间西安高新医院收治的116例ACS患者作为观察组,选取同期体检中心体检健康者100例作为对照组。比较两组受检者的血清HMGB1、LP-PLA2、IMA的表达水平,利用受试者工作曲线(ROC)分析其诊断ACS的效能,采用Pearson相关性分析HMGB1、LP-PLA2、IMA与心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶MB(CK-MB)的相关性。根据患者预后情况分为预后不良组34例和预后良好组82例,采用多因素Logistic回归分析影响患者预后不良的独立危险因素。结果观察组患者的血清HMGB1、LP-PLA2、IMA、cTnT、CK-MB水平分别为(9.21±1.77)ng/mL、(330.58±65.7)g/mL、(85.47±17.22)U/mL、(3.23±0.78)μg/L、(23.48±5.39)U/L,明显高于对照组的(3.25±0.48)ng/mL、(131.47±32.29)g/mL、(52.37±9.79)U/mL、(0.05±0.01)μg/L、(2.14±0.55)U/L,差异均有统计学意义(P<0.05);三者联合检测的曲线下面积(AUC)为0.863,灵敏度和特异度分别为88.1%、90.0%;经Pearson相关性分析结果显示,HMGB1、LP-PLA2、IMA与cTnT、CK-MB呈正相关(P<0.05);预后不良组患者的HMGB1、LP-PLA2、IMA分别为(10.56±2.01)ng/mL、(378.44±72.69)ng/mL、(96.33±20.02)U/mL,明显高于预后良好组的(8.64±1.59)ng/mL、(310.73±61.88)ng/mL、(80.96±15.52)U/mL,差异均有统计学意义(P<0.05);经Logistic回归分析结果显示,HMGB1、LP-PLA2、IMA是ACS患者预后不良的独立危险因素(P<0.05)。结论急性冠脉综合征患者血清HMGB1、LP-PLA2、IMA表达水平明显升高,是患者预后不良的独立危险因素,联合检测有助于早期诊断和预后评估。Objective To investigate the expression levels of serum high mobility protein 1(HMGB1),lipopro-tein-associated phospholipase A2(LP-PLA2),and ischaemic modified protein(IMA)in patients with acute coronary syn-drome(ACS)and analyze their correlation with prognosis.Methods A total of 116 patients with ACS admitted to Xi'an High-tech Hospital from January 2020 to December 2020 were selected as the observation group,and 100 healthy patients from Physical Examination Center during the same period were selected as the control group.The expression levels of serum HMGB1,LP-PLA2,and IMA were compared between the two groups,and the diagnostic efficacy of ACS was analyzed by receiver operating curve(ROC).Pearson correlation was used to analyze the correlation of HMGB1,LP-PLA2,and IMA with cardiac troponin T(cTnT)and creatine kinase isoenzyme MB(CK-MB).Patients were divided into a poor prognosis group(34 cases)and a good prognosis group(82 cases)according to the prognosis.Multiple Logistic regression was used to analyze the independent risk factors affecting the poor prognosis.Results Se-rum HMGB1,LP-PLA2,IMA,cTnT,CK-MB levels were(9.21±1.77)ng/mL,(330.58±65.7)g/mL,(85.47±17.22)U/mL,(3.23±0.78)μg/L,(23.48±5.39)U/L in the observation group,respectively,significantly higher than(3.25±0.48)ng/mL,(131.47±32.29)g/mL,(52.37±9.79)U/mL,(0.05±0.01)μg/L,(2.14±0.55)U/L in the control group(P<0.05).The area under the curve(AUC)was 0.863,and the sensitivity and specificity were 88.1%and 90.0%,respectively.Pearson corre-lation analysis showed that HMGB1,LP-PLA2,and IMA were positively correlated with cTnT and CK-MB(P<0.05).The HMGB1,LP-PLA2,and IMA in the poor prognosis group were(10.56±2.01)ng/mL,(378.44±72.69)ng/mL,and(96.33±20.02)U/mL,respectively,significantly higher than(8.64±1.59)ng/mL,(310.73±61.88)ng/mL,(80.96±15.52)U/mL in good prognosis group(P<0.05).Logistic regression analysis showed that HMGB1,LP-PLA2,and IMA were indepen-dent risk factors for poor prognosis in ACS patients(P<0.05).Conclusion Serum HMGB1,LP-P

关 键 词：急性冠脉综合征 高迁移率蛋白1 脂蛋白相关磷脂酶A2 缺血修饰蛋白 诊断 预后 

分 类 号：R541.4[医药卫生—心血管疾病]