急性冠脉综合征患者血清GRP78、suPAR水平与心血管预后的关系及预测价值研究  

Relationship between serum GRP78,suPAR levels and cardiovascular prognosis in patients with acute coronary syndrome and their predictive value

作　　者：陈晶晶 丁帆 杨萍 CHEN Jing-jing;DING Fan;YANG Ping(Department of Laboratory,Wuhan No.6 Hospital Affiliated to Jianghan University,Wuhan Hubei 430014,China;Department of Cardiovascular Medicine,Wuhan No.6 Hospital Affiliated to Jianghan University,Wuhan Hubei 430014,China)

机构地区：[1]江汉大学附属武汉市第六医院检验科,湖北武汉430014 [2]江汉大学附属武汉市第六医院心血管内科,湖北武汉430014

出　　处：《临床和实验医学杂志》2024年第14期1482-1485,共4页Journal of Clinical and Experimental Medicine

基　　金：湖北省卫生健康委员会联合基金项目(编号:WJ2019H339)。

摘　　要：目的探讨急性冠脉综合征(ACS)患者血清葡萄糖调节蛋白78(GRP78)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)水平与心血管预后的相关性及预测价值研究。方法回顾性纳入2021年11月至2022年3月江汉大学附属武汉市第六医院收治的ACS患者179例作为ACS组,并选取冠脉造影检查正常的受检者80例作为对照组,均行血清GRP78、suPAR水平的测定并比较。按随访1年是否发生主要不良心血管事件(MACE)将患者分为预后不良组(发生MACE,n=31)与预后良好组(未发生MACE,n=148)。比较不同预后ACS患者的一般资料[性别、年龄、吸烟史、饮酒史、冠心病家族史、体重指数、既往病史、疾病诊断、收缩压、舒张压和左室射血分数(LVEF)等]和实验室指标[空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、血肌酐、尿素氮和脑利钠肽、GRP78、suPAR水平]差异,并采用多因素Logistic回归分析影响ACS患者预后的因素,采用受试者操作特征(ROC)曲线评价GRP78、suPAR对ACS患者预后的预测能力。结果ACS组血清GRP78、suPAR水平分别为(1.42±0.43)、(2.59±0.65)ng/mL,均高于对照组[(1.01±0.35)、(1.54±0.43)ng/mL],差异均有统计学意义(P<0.05)。预后不良组的LVEF为(55.47±7.58)%,低于预后良好组[(59.44±10.25)%],血清脑利钠肽、GRP78及suPAR水平分别为(156.25±29.27)pg/mL、(1.72±0.51)ng/mL、(3.08±0.64)ng/mL,均高于预后良好组[(142.54±26.37)pg/mL、(1.36±0.39)ng/mL、(2.49±0.57)ng/mL],差异均有统计学意义(P<0.05);两组其余各项一般资料和实验室指标比较,差异均无统计学意义(P>0.05)。Logistic回归分析得出,较高GRP78水平和较高suPAR水平是ACS患者预后不良的危险因素(OR=1.669,95%CI:1.186~2.347;OR=1.517,95%CI:1.133~2.032;P<0.05),LVEF是其保护因素(OR=0.674,95%CI:0.507~0.898;P<0.05)。ROC曲线分析得出,GRP78、suPAR预测ACS患者不良预后的曲线下面积(AUC)分别为0.708、0.747,二者联合的AUC达Objective To investigate the relationship between serum glucose-regulated protein 78(GRP78),soluble urokinase-type plasminogen activator receptor(suPAR)levels and cardiovascular prognosis in patients with acute coronary syndrome(ACS)and thein predictive value.Methods A total of 179 patients with ACS admitted to Wuhan No.6 Hospita Affiliated to Jianghan University from November 2021 to March 2022 were retrospectively included as the ACS group,and 80 subjects with normal coronary angiography were selected as the control group.The levels of serum GRP78 and suPAR were measured and compared.According to the occurrence of major adverse cardiovascular events(MACE)during the 1-year follow-up,the patients were divided into the poor prognosis group(with MACE,n=31)and the good prognosis group(without MACE,n=148).The differences of general information[gender,age,smoking history,drinking history,family history of coronary heart disease,body mass index,past medical history,disease diagnosis,systolic blood pressure,diastolic blood pressure,and left ventricular ejection fraction(LVEF)]and laboratory indicators[fasting blood glucose,total cholesterol,triglycerides,low-density lipoprotein cholesterol(LDL-C),blood creatinine,urea nitrogen,and brain natriuretic peptide,GRP78,suPAR levels]of ACS patients with different prognoses were compared.The factors affecting the prognosis of ACS patients were analyzed using multivariate logistic regression analysis.The prognostic predictive value of GRP78 and suPAR for the prognosis of ACS patients was evaluated by receiver operating characteristic(ROC)curve.Results The serum levels of GRP78 and suPAR in the ACS group were(1.42±0.43)and(2.59±0.65)ng/mL,respectively,which were higher than those in the control group[(1.01±0.35)and(1.54±0.43)ng/mL],and the differences were statistically significant(P<0.05).The LVEF of the poor prognosis group was(55.47±7.58)%,which was lower than that of the good prognosis group[(59.44±10.25)%],the levels of serum brain natriuretic peptide,GRP78,and suPAR of

关 键 词：急性冠脉综合征 心血管预后 葡萄糖调节蛋白78 可溶性尿激酶型纤溶酶原激活物受体 

分 类 号：R541.4[医药卫生—心血管疾病]