血清MOTS-c、sLRP-1水平与急性冠状动脉综合征严重程度及预后的相关性  

Relationship of serum MOTS-c and sLRP-1 levels with the severity and prognosis of patients with acute coronary syndrome

作　　者：王美娟 时涵远 李娇 魏丽萍[2] WANG Meijuan;SHI Hanyuan;LI Jiao;WEI Liping(Graduate School,Tianjin Medical University,Tianjin,300070,China;Department of Cardiology,Tianjin People's Hospital)

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市人民医院心脏内科

出　　处：《临床心血管病杂志》2023年第7期516-520,共5页Journal of Clinical Cardiology

基　　金：国家自然科学基金面上项目(No:52173285);京津冀基础研究合作专项(No:19JCZDJC63900);天津市卫生健康科技项目(No:TJWJ2022QN037)。

摘　　要：目的:测定急性冠状动脉综合征(ACS)患者血清线粒体衍生肽(MOTS-c)和可溶性低密度脂蛋白受体相关蛋白-1(sLRP-1)水平,探究其与冠状动脉(冠脉)病变严重程度及预后的相关性。方法:选取行冠脉造影(CAG)患者240例,其中不稳定心绞痛患者109例(UAP组),急性心肌梗死患者79例(AMI组),CAG正常者52例(对照组)。收集患者一般资料并测定血清MOTS-c、sLRP-1水平。根据CAG结果评估冠脉病变支数和病变程度,记录患者平均随访10个月中的主要不良心血管事件(MACEs)发生情况。结果:与对照组比较,UAP组和AMI组患者血清MOTS-c水平均明显降低,sLRP-1水平明显升高,且AMI组患者血清MOTS-c水平显著低于UAP组,sLRP-1水平显著高于UAP组,均差异有统计学意义(均P<0.05)。随着病变程度加重,血清MOTS-c水平逐渐降低,sLRP-1水平逐渐升高(P<0.05)。单支病变组、双支病变组、多支病变组患者血清MOTS-c水平依次降低,sLRP-1水平依次升高(P<0.05)。Spearman分析显示,ACS患者血清MOTS-c水平与MACEs呈负相关(r=-0.381,P<0.001),sLRP-1水平与MACEs呈正相关(r=0.338,P<0.001)。血清MOTS-c、sLRP-1水平对ACS患者的预后具有预测价值,曲线下面积分别为0.762、0.732,灵敏度分别为86.0%、83.7%,特异度分别为64.8%、67.6%。结论:血清MOTS-c水平降低、sLRP-1水平升高与ACS患者病情严重程度及预后不良相关。Objective To measure the serum levels of MOTS-c and sLRP-1 in patients with acute coronary syndrome(ACS) and to investigate their relationship with the severity of coronary lesions and prognosis.Methods Two hundred and forty patients who underwent coronary angiography(CAG) were selected and divided into unstable angina group(n=109), acute myocardial infarction group(n=79), and control group(n=52). General data were collected and serum MOTS-c and sLRP-1 levels were measured. The number of coronary lesion branches and the extent of lesions were assessed according to the CAG results, and the occurrence of major adverse cardiovascular events(MACEs) was recorded during the 10-month follow-up.Results Compared with the control group, serum MOTS-c levels were significantly lower and sLRP-1 levels were significantly higher in both the UAP and AMI groups, and serum MOTS-c levels were significantly lower and sLRP-1 levels were significantly higher in the AMI group than those in the UAP group(all P < 0.05). Serum MOTS-c levels gradually decreased and sLRP-1 levels gradually increased with the increase of lesion degree(P < 0.05). The serum MOTS-c levels decreased and sLRP-1 levels increased in the single-branch lesion group, the double-branch lesion group, and the multi-branch lesion group in that order(P < 0.05). Spearman analysis showed that the serum MOTS-c level in ACS patients was negatively correlated with MACEs(r=-0.381, P < 0.001), and the sLRP-1 level was positively correlated with MACEs(r=0.338, P < 0.001). Serum MOTS-c and sLRP-1 levels had a predictive value for the prognosis of ACS patients, whose areas under the curve were 0.762 and 0.732, with sensitivity of 86.0% and 83.7%, and specificity of 64.8% and 67.6%, respectively.Conclusion Decreased serum MOTS-c levels and increased sLRP-1 levels are associated with severity and poor prognosis in patients with ACS.

关 键 词：急性冠状动脉综合征 MOTS-c sLRP-1 主要不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]