急性心肌梗死患者血清NRG1、ACSL1与冠状动脉狭窄程度及预后的相关性研究  

The correlation between serum NRG1,ACSL1 and the degree of coronary stenosis and prognosis in patients with acute myocardial infarction

作　　者：刘海燕 湛小波 徐秀兰 陈凤 杜巧 谭丹 Liu Haiyan;Zhan Xiaobo;Xu Xiulan;Chen Feng;Du Qiao;Tan Dan(Department of Emergency Medicine,Second Affiliated Hospital of Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院急诊医学科,重庆400037

出　　处：《疑难病杂志》2024年第12期1419-1424,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：重庆市自然基金面上项目(CSTB2022NSCQ-MSX0158)。

摘　　要：目的探讨急性心肌梗死(AMI)患者血清神经调节素1(NRG1)、酰基辅酶A合成酶长链家族成员1(ACSL1)与冠状动脉狭窄程度及预后的相关性。方法选取2021年1月—2023年6月陆军军医大学第二附属医院经急诊医学科收治的AMI患者203例为AMI组,同期健康体检志愿者105例为健康对照组,AMI患者根据Gensini评分分为轻度冠脉狭窄亚组(63例)、中度冠脉狭窄亚组(81例)和重度冠脉狭窄亚组(59例);根据1年预后随访分为不良预后亚组(52例)和良好预后亚组(151例)。采用酶联免疫吸附法检测血清NRG1、ACSL1水平。Spearman相关性分析AMI患者Gensini评分与血清NRG1、ACSL1水平的相关性;多因素非条件Logistic回归分析血清NRG1、ACSL1水平与AMI患者预后的关系;受试者工作特征曲线分析血清NRG1、ACSL1水平对不良预后预测效能。结果与健康对照组比较,AMI组血清NRG1、ACSL1水平升高(t/P=15.801/<0.001、15.824/<0.001)。轻度冠脉狭窄亚组、中度冠脉狭窄亚组、重度冠脉狭窄亚组血清NRG1、ACSL1水平依次升高(F/P=277.241/<0.001、423.452/<0.001)。AMI患者Gensini评分与血清NRG1、ACSL1水平呈正相关(r s/P=0.764/<0.001、0.772/<0.001)。随访1年,203例AMI患者不良预后发生率为25.62%(52/203)。与良好预后亚组比较,不良预后亚组血清NRG1、ACSL1水平升高(t/P=7.040/<0.001、7.865/<0.001)。Gensini评分高、ACSL1高、NRG1高为AMI患者不良预后的独立危险因素[OR(95%CI)=1.041(1.019~1.062)、1.272(1.120~1.443)、1.337(1.193~1.497)]。血清NRG1、ACSL1水平联合预测AMI患者不良预后的曲线下面积为0.899,大于血清NRG1、ACSL1水平单独预测的0.783、0.786(Z/P=3.730/<0.001、3.329/<0.001)。结论AMI患者血清NRG1、ACSL1水平升高,与冠脉狭窄程度加重和不良预后有关,血清NRG1、ACSL1水平联合预测AMI患者预后的效能较高。Objective To investigate the correlation of serum neuromodulin 1(NRG1)and acyl-coenzyme A synthetase long chain family member 1(ACSL1)with the degree of coronary stenosis and prognosis in patients with acute myocardial infarction(AMI).Methods From January 2021 to June 2023,203 patients with AMI admitted to the Department of Emergency Medicine of the Second Affiliated Hospital of Army Medical University were selected as AMI group and 105 healthy volunteers were selected as healthy control group.According to Gensini score,AMI patients were divided into mild coronary stenosis subgroup(63 cases),moderate coronary stenosis subgroup(81 cases)and severe coronary stenosis subgroup(59 cases).According to 1-year prognosis,they were divided into poor prognosis subgroup(52 cases)and good prognosis subgroup(151 cases).Serum NRG1 and ACSL1 levels were detected by enzyme-linked immunosorbent assay.Serum NRG1 and ACSL1 levels were detected by enzyme-linked immunosorbent assay.Spearman correlation analysis was used to analyze the correlation between Gensini score and serum NRG1 and ACSL1 levels in AMI patients.The relationship between serum NRG1 and ACSL1 levels and the prognosis of AMI patients was determined by multivariate unconditional logistic regression.Receiver operating characteristic curve was used to analyze the predictive efficiency of serum NRG1 and ACSL1 levels.Results Compared with the control group,the serum levels of NRG1 and ACSL1 in the AMI group were increased(t/P=15.801/<0.001,15.824/<0.001).The levels of serum NRG1 and ACSL1 in mild coronary stenosis subgroup,moderate coronary stenosis subgroup and severe coronary stenosis subgroup increased in turn(F/P=277.241/<0.001,423.452/<0.001).Gensini score was positively correlated with serum NRG1 and ACSL1 levels in AMI patients(r s/P=0.764/<0.001,0.772/<0.001).The incidence of poor prognosis in 203 patients with AMI was 25.62%(52/203)after 1 year of follow-up.Compared with the good prognosis subgroup,the serum levels of NRG1 and ACSL1 in the poor prognosis subgroup

关 键 词：急性心肌梗死 神经调节素1 酰基辅酶A合成酶长链家族成员1 冠状动脉狭窄程度 预后 

分 类 号：R541.4[医药卫生—心血管疾病]