血清S100A12、sRAGE水平与AMI患者PCI术后冠状动脉无复流的相关性分析  

Correlation between levels of serum S100A12 and sRAGE and coronary no-reflow after PCI in patients with acute myocardial infarction

作　　者：张明磊 高建步[1] 王星[1] 解莉莉 Zhang Minglei;Gao Jianbu;Wang Xing;Xie Lili(Department of Cardiovascular Medicine,Central Hospital of Nanyang City,Henan Province,Nanyang 473009,China;不详)

机构地区：[1]河南省南阳市中心医院心血管内科,南阳473009

出　　处：《中国循证心血管医学杂志》2023年第3期306-310,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191459)。

摘　　要：目的研究血清S100钙结合蛋白A12(S100A12)、可溶性晚期糖基化终末产物受体(sRAGE)水平与急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后冠状动脉(冠脉)无复流的相关性。方法选取2017年7月至2020年10月于南阳市中心医院心血管内科收治确诊的258例行PCI的AMI患者,根据术中即刻心肌梗死溶栓(TIMI)血流分级分为复流组(n=176)和无复流组(n=82)。全自动生化分析仪检测两组患者行PCI前总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平;ELISA法检测血清超敏C反应蛋白(hs-CRP)、S100A12和sRAGE水平;采用Pearson相关系数法对S100A12和sRAGE的相关性进行分析;使用Logistic回归分析影响AMI患者PCI术后冠脉无复流的因素;ROC工作特征曲线评估S100A12和sRAGE对AMI患者PCI后冠脉无复流的预测价值。结果与复流组相比,无复流组患者血清中hs-CRP、S100A12水平显著增加,而sRAGE水平显著降低(P<0.05);无复流组患者血清中S100A12和sRAGE水平呈显著负相关(r=-0.476,P=0.000);多因素Logistic回归分析发现S100A12高水平、sRAGE低水平、发生血栓高负荷和hs-CRP高水平均是导致PCI后无复流发生的独立危险因素(P<0.05);S100A12预测无复流发生的ROC曲线下面积为0.858,灵敏度87.80%,特异性71.59%;sRAGE预测无复流发生的ROC曲线下面积为0.909,灵敏度90.24%,特异性76.70%;S100A12和sRAGE联合预测无复流发生的ROC曲线下面积为0.939,灵敏度90.24%,特异性85.23%。结论S100A12水平增加和sRAGE水平降低与AMI患者PCI术后冠脉无复流的发生密切相关,二者均是无复流发生的独立危险因素,两者联合对预测无复流发生具有较高的评估价值。Objective To study the correlation between levels of serum S100 calcium-binding protein A12(S100A12)and soluble receptor for advanced glycation end products(sRAGE)and coronary no-reflow after PCI in patients with acute myocardial infarction(AMI).Methods AMI patients(n=258)undergone PCI were chosen from July 2017 to Oct.2020,and divided,according to TIMI flow grades,into reflow group(n=176)and no-reflow group(n=82).The levels of total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)were detected by using automatic biochemical analyzer in 2 groups before PCI.The levels of serum high-sensitivity C-reactive protein(hs-CRP),S100A12 and sRAGE were detected by using ELISA.The correlation between S100A12 and sRAGE was analyzed by using Pearson method.The factors influencing coronary no-reflow were analyzed by using Logistic regression analysis in AMI patients after PCI.The predictive value of S100A12 and sRAGE to coronary no-reflow was reviewed by using ROC curve in AMI patients after PCI.Results Compared with reflow group,levels of hs-CRP and S100A12 increased significantly,and sRAGE level decreased significantly in no-reflow group(P<0.05).S100A12 level was negatively correlated to sRAGE level in no-reflow group(r=-0.476,P=0.000).The results of multi-factor Logistic regression analysis showed that high S100A12 level,low sRAGE level,high thrombus load and high hs-CRP level all were independent risk factors of no-reflow after PCI(P<0.05).The area under ROC curve of S100A12 was 0.858,sensitivity was 87.80%and specificity was 71.59%.The area under ROC curve of sRAGE in predicting no-reflow was 0.909,sensitivity was 90.24%and specificity was 76.70%.The area under ROC curve of S100A12 combined with sRAGE in predicting no-reflow was 0.939,sensitivity was 90.24%and specificity was 85.23%.Conclusion The increase of S100A12 level and decrease of sRAGE level are closely correlated to coronary no-reflow in AMI patients after PCI,they are independent risk fac

关 键 词：经皮冠状动脉介入治疗 急性心肌梗死 无复流 S100钙结合蛋白A12 可溶性晚期糖基化终末产物受体 

分 类 号：R542.22[医药卫生—心血管疾病]