血清ITLN-1、XBP1S水平对心肌梗死PCI患者预后的预测价值  

Prognostic value of a combinationdetection of serum ITLN-1 and XBP1S levels in patients with myocardial infarction after percutaneous coronary intervention

作　　者：魏燕 胡丽君 何涛 宋之哲 陈芬[2] WEI Yan;HU Lijun;HE Tao(Department of Cardiology,Hubei Jianghan Oilfield General Hospital,Hubei,Qianjiang 433000,China)

机构地区：[1]湖北江汉油田总医院心内科,湖北省潜江市433000 [2]华中科技大学同济医学院附属协和医院心内科、生物靶向治疗研究湖北省重点实验室、心血管疾病免疫诊疗湖北省工程研究中心

出　　处：《河北医药》2023年第17期2571-2575,共5页Hebei Medical Journal

基　　金：国家自然科学科学基金项目(编号:81300196);湖北省自然科学基金(编号:WJ2019F152)。

摘　　要：目的探讨血清新型细胞因子内分泌素(1ITLN-1)、剪接型X-盒结合蛋白(1XBP1S)水平联合检测对心肌梗死(MI)经皮冠状动脉介入(PCI)患者术后的预后预测价值。方法纳入2018年1月至2021年1月接收的因患MI进行PCI术的患者120例(试验组),根据MI患者PCI术后预后发生情况将其分为预后良好组(82例)和预后不良组(38例),选取同期健康体检者100例为对照组。酶联免疫吸附(ELISA)法检测血清ITLN-1、XBP1S水平,COX多因素回归分析MI患者PCI术后预后不良事件的影响因素,受试者工作曲线(ROC)评价血清ITLN-1、XBP1S在MI中的临床意义。结果与对照组比较,试验组患者血清ITLN-1显著降低,XBP1S显著升高,差异统计学意义(P<0.05)。与预后良好组比较,预后不良组患者血清ITLN-1显著降低,IL-1β、IL-6、IL-8、TNF-α、XBP1S显著升高,差异有统计学意义(P<0.05)。多因素COX回归分析显示,TNF-α、XBP1S均是MI患者PCI术后预后不良的独立危险因素(P<0.05)。高水平ITLN-1是冠心病患者PCI术后预后不良的独立保护因素(P<0.05)。ROC结果显示,血清ITLN-1、XBP1S水平及二者联合预测MI患者PCI术后预后不良的AUC分别为0.701、0.728、0.846,其中联合预测AUC显著高于二者单独预测AUC(Z=4.075、4.410,P<0.05)。结论MI患者PCI术后患者血清ITLN-1水平降低、XBP1S水平升高,与不良预后的发生关系密切,均有望成为MI患者PCI术后不良预后发生的预测因子。Objective To explore the prognostic value of a combinationdetection of serum intelectin-1(ITLN-1)and spliced X-box binding protein 1(1XBP1S)levels in patients with myocardial infarction(MI)after percutaneous coronary intervention(PCI).Methods From January 2018 to January 2021,a total of 120 MI patients treated with PCI in our hospital were included.According to the prognosis after PCI,they were divided into good prognosis group(n=82)and poor prognosis group(n=38).A total of 100 health volunteers receiving physical examinationsin the same period were selected as the control group.Serum levels of ITLN-1 and XBP1S were detected by enzyme-linked immunosorbent assay(ELISA).Multivariate Cox regression analysis was performed to analyze the influencing factors for adverse events of these patients.Clinical significance of serum ITLN-1 and XBP1S in diagnosing MI was evaluated by plotting the receiver operating characteristic(ROC)curves.Results Compared with those of the control group,serum ITLN-1 was significantly lower and serum XBP1S was significantly higher in MI patients(P<0.05).Compared with MIpatients with good prognosis,those with poor prognosis had significantlylower serum ITLN-1,and higher serum levels of IL-1,IL-6,IL-8,TNF,and XBP1S(P<0.05).Multivariate COX regression analysis showed that serum levels of TNF and XBP1S were independent risk factors for poor prognosis of MI patients after PCI(P<0.05),and the high level of ITLN-1 was an independent protective factor(P<0.05).ROC results showed that the area under the curve(AUC)of detectingserum ITLN-1 and XBP1S and their combination detection in predicting poor prognosis in MI patients after PCI was 0.701,0.728 and 0.846,respectively.The AUC of the combinationprediction was significantlyhigher than that of single detection(Z=4.075,and 4.410,respectively;both P<0.05).Conclusion Serum ITLN-1 decreases and serum XBP1S increases in MI patients after PCI,which are correlated with the poor prognosis.They are promising biomarkers for predicting the poor prognosis of MI afte

关 键 词：心肌梗死 经皮冠状动脉介入术 新型细胞因子内分泌素1 剪接型X-盒结合蛋白1 不良预后 

分 类 号：R542.22[医药卫生—心血管疾病]