急性冠状动脉综合征患者血清糖原合成酶激酶-3β和母亲DPP同源物4的表达及临床意义  

Expression and clinical significance of serum glycogen synthase kinase-3βand mothers against decapentaplegic homolog 4 in patients with acute coronary syndrome

作　　者：陈儒 栾璐璐 李海岩 陈可斌 王均志 Chen Ru;Luan Lulu;Li Haiyan;Chen Kebin;Wang Junzhi(Department of Cardiovascular Medicine,Shandong First Medical University Affiliated Qingdao Hospital(Qingdao Chengyang District People's Hospital),Qingdao 266109,China)

机构地区：[1]山东第一医科大学附属青岛医院(青岛市城阳区人民医院)心血管内科,青岛266109

出　　处：《中国医师进修杂志》2024年第5期403-408,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨急性冠状动脉综合征(ACS)患者血清糖原合成酶激酶-3β(GSK-3β)和母亲DPP同源物4(SMAD4)表达水平与冠状动脉病变程度和预后的关系。方法回顾性选取2020年6月至2022年5月山东第一医科大学附属青岛医院收治的192例ACS患者为ACS组,同期收治的192例非ACS患者为非ACS组。通过酶联免疫吸附法测定两组患者血清GSK-3β、SMAD4表达水平。采用Gensini积分系统评价患者冠状动脉病变程度,并采用Spearman法分析ACS患者血清GSK-3β、SMAD4表达水平与Gensini总积分的相关性。采用受试者工作特征(ROC)曲线分析血清GSK-3β、SMAD4水平对ACS患者预后的预测效能。结果ACS组患者血清GSK-3β、SMAD4水平均高于非ACS组[(2.70±0.40)μg/L比(2.24±0.41)μg/L、(12.19±2.10)μg/L比(9.79±2.82)μg/L],差异有统计学意义(P<0.05)。轻度、中度、重度冠状动脉病变ACS患者血清GSK-3β、SMAD4水平均依次升高,差异有统计学意义(P<0.05)。Spearman分析结果显示,ACS患者血清GSK-3β、SMAD4水平均与Gensini总积分呈正相关(r=0.569、0.587,P<0.01)。ACS患者预后不良48例,预后不良发生率为25.00%(48/192);预后良好144例。预后不良ACS患者血清GSK-3β、SMAD4水平均高于预后良好ACS患者[(3.15±0.53)μg/L比(2.55±0.36)μg/L、(14.03±2.08)μg/L比(11.58±2.11)μg/L],差异有统计学意义(P<0.05)。ROC曲线分析结果显示,血清GSK-3β、SMAD4水平单独与联合预测ACS患者预后不良的曲线下面积(AUC)分别为0.799、0.784、0.858,二者联合预测的AUC显著高于单独预测的AUC(Z=2.04和2.75,P=0.041和0.006)。结论ACS患者血清GSK-3β、SMAD4表达异常升高,二者与ACS患者冠状动脉病变程度正相关,均对ACS患者不良预后有良好预测效能,且二者联合运用的预测效能更好。Objective To investigate the relationship between the expression levels of serum glycogen synthase kinase-3β(GSK-3β)and mothers against decapentaplegic homolog 4(SMAD4)in patients with acute coronary syndrome(ACS)and the severity and prognosis of coronary artery disease.Methods A total of 192 ACS patients admitted to Shandong First Medical University Affiliated Qingdao Hospital from June 2020 to May 2022 were selected as the ACS group,while 192 non ACS patients admitted to the same hospital were selected as the non ACS group.Enzyme-linked immunosorbent assay method was applied to determine the expression levels of serum GSK-3βand SMAD4 in two groups.The Gensini score was applied to evaluate the degree of coronary artery disease in patients,Spearman method was applied to analyze the correlation between serum GSK-3β,SMAD4 expression levels and Gensini score in ACS patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive efficacy of serum GSK-3βand SMAD4 levels on the prognosis of ACS patients.ResultsThe serum levels of GSK-3βand SMAD4 in the ACS group were significantly higher than those in the non ACS group:(2.70±0.40)μg/L vs.(2.24±0.41)μg/L,(12.19±2.10)μg/L vs.(9.79±2.82)μg/L,and there were statistical differences(P<0.05).The serum levels of GSK-3βand SMAD4 in ACS patients with mild,moderate and severe coronary artery disease increased sequentially(P<0.05).Spearman analysis showed that serum GSK-3βand SMAD4 levels in ACS patients were positively correlated with Gensini total score(r=0.569 and 0.587,P<0.01).In ACS patients,48 cases had poor prognosis,and the incidence of poor prognosis was 25.00%(48/192);144 cases had a good prognosis.The serum levels of GSK-3βand SMAD4 in ACS patients with poor prognosis were significantly higher than those in ACS patients with good prognosis:(3.15±0.53)μg/L vs.(2.55±0.36)μg/L,(14.03±2.08)μg/L vs.(11.58±2.11)μg/L,and there were statistical differences(P<0.05).The ROC curve result indicated that the area under the curve(AU

关 键 词：急性冠状动脉综合征 糖原合成酶激酶-3Β 母亲DPP同源物4 冠状动脉病变程度 预后 

分 类 号：R541.4[医药卫生—心血管疾病]