急性ST段抬高心肌梗死患者血清ADAMTS13、SFRP5、hs-CRP的表达及临床意义  

Expression and clinical significance of serum ADAMTS13,SFRP5 and hs-CRP in patients with acute ST segment elevation myocardial infarction

作　　者：陈国英 孟坚强 张志诚 盛西陵 CHEN Guoying;MENG Jianqiang;ZHANG Zhicheng;SHENG Xiling(Department of Cardiology,Shaoxing Central Hospital,Shaoxing 312030,China;不详)

机构地区：[1]绍兴市中心医院心内科,312030 [2]嘉兴市第一医院心内科

出　　处：《心电与循环》2024年第3期230-234,共5页Journal of Electrocardiology and Circulation

基　　金：浙江省医药卫生科技计划项目(2018ZH043)。

摘　　要：目的 分析急性ST段抬高心肌梗死(ASTEMI)患者血管性血友病因子裂解酶13(ADAMTS13)、分泌型卷曲相关蛋白5(SFRP5)、超敏C反应蛋白(hs-CRP)的表达及临床意义。方法 回顾性分析2020年1月至2021年1月绍兴市中心医院收治的134例ASTEMI患者(ASTEMI组)的临床资料,另择本院同期健康体检者76人作为对照组。比较组间ADAMTS13、SFRP5、hs-CRP水平,对ASTEMI组患者随访1年。根据主要不良心血管事件(MACE)发生情况分为预后不良亚组和预后良好亚组。采用多因素logistic回归分析ASTEMI患者预后不良的影响因素。结果 ASTEMI组ADAMTS13、SFRP5表达水平低于对照组,hs-CRP表达高于对照组(均P<0.01)。不同Killip分级患者ADAMTS13、SFRP5表达水平为:Ⅰ级>Ⅱ级>Ⅲ级>Ⅳ级,hs-CRP表达水平为:Ⅰ级<Ⅱ级<Ⅲ级<Ⅳ级(均P<0.05)。ASTEMI组中,26例患者预后不良,预后不良亚组支架置入个数、冠状动脉多支病变率、Killip分级≥Ⅱ级占比、hs-CRP水平、左心室射血分数(LVEF)值均高于预后良好亚组,ADAMTS13、SFRP5表达水平均低于预后良好亚组(均P<0.01)。多因素logistic回归分析显示支架置入个数、冠状动脉多支病变率、Killip分级、hs-CRP、LVEF、ADAMTS13、SFRP5均为ASTEMI患者预后不良的影响因素(均P<0.05)。结论ASTEMI患者ADAMTS13、SFRP5降低,hs-CRP升高,与患者心功能及预后密切相关。Objective To analyze the expression and clinical significance of of ADAMTS13,SFRP5,and hs-CRP in patients with acute ST segment elevation myocardial infarction(ASTEMI).Methods The clinical data of 134 ASTEMI patients(ASTEMI group)admitted to Shaoxing Central Hospital from January 2020 to January 2021 were retrospectively analyzed,and 76 healthy individuals who underwent physical examinations at the same time were selected as the control group.ADAMTS13,SFRP5 and hs-CRP were compared between the two groups.According to the occurrence of major adverse cardiovascular events(MACE)during one year follow-up,ASTEMI group was divided into poor prognosis subgroup and good prognosis subgroup.Multiple logistic regression was used to analyze the influencing factors for poor prognosis in ASTEMI patients.Results ADAMTS13 and SFRP5 were significantly lower and hs-CRP was significantly higher in ASTEMI group than in the control group(all P<0.01).The expressions of ADAMTS13 and SFRP5 in patients with different Killip grades were:gradeⅠ>gradeⅡ>gradeⅢ>gradeⅣ,the expressions of hs-CRP were:gradeⅠ<gradeⅡ<gradeⅢ<gradeⅣ(all P<0.05).Among 134 ASTEMI patients,26 patients had poor prognosis.The number of stents,the rate of multivessel diseases,the proportion of Killip score≥Ⅱ,hs-CRP level and LVEF in the poor prognosis group were significantly higher than those in the good prognosis group, while ADAMTS13 and SFRP5 were lower than those in the good prognosis group (all P<0.01). Logistic regression analysis showed that the number of stents, the rate of multivessel diseases, Killip grade, hs-CRP, LVEF, ADAMTS13, and SFRP5 were associated with poor prognosis of ASTEMI patients (all P<0.05). Conclusion ADAMTS13 and SFRP5 decrease, while hs-CRP increases in ASTEMI patients, which are closely related to cardiac function and prognosis.

关 键 词：急性ST段抬高心肌梗死 血管性血友病因子裂解酶13 超敏C反应蛋白 分泌型卷曲相关蛋白5 预后 

分 类 号：R542.22[医药卫生—心血管疾病]