富含Gla蛋白水平与急性冠脉综合征患者PCI后主要不良心血管事件发生风险的关系  

A study of the relationship between Gla-rich protein levels and the risk of major adverse cardiovascular events after PCI in patients with acute coronary syndrome

作　　者：李萌 闫小菊 苏亚坤 张慧晶 曹静 LI Meng;YAN Xiaoju;SU Yakun;ZHANG Huijing;CAO Jing(Department of Cardiology,Hengshui People's Hospital,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市人民医院心血管内科,衡水053000

出　　处：《医学研究与战创伤救治》2025年第1期56-62,共7页Journal of Medical Research & Combat Trauma Care

基　　金：衡水市科技计划项目(2021014086Z)。

摘　　要：目的探讨血清富含Gla蛋白(GRP)水平与急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)后主要不良心血管事件(MACE)发生风险的关系。方法选择2020年6月至2022年1月衡水市人民医院心血管内科收治的120例ACS患者作为ACS组。根据PCI术后6个月内MACE发生情况分为MACE组(22例)和非MACE组(98例)。选择同期于本院体检的100例健康者作为对照组。收集所有受试者的临床资料。采用酶联免疫吸附法检测血清GRP水平,根据GRP水平分为低水平GRP组和高水平GRP组。绘制ROC曲线评价血清GRP诊断ACS的效能。采用Logistic回归分析影响ACS发生的风险因素。采用Kaplan-Meier法和Cox回归分析血清GRP对MACE的预测价值。结果与对照组相比,ACS组患者血清GRP水平显著降低(P<0.05)。ACS患者血清GRP水平与Gensini评分和GRACE评分均呈明显负相关(P<0.05)。血清GRP诊断ACS的AUC为0.736(95%CI:0.668~0.804),敏感性为80.00%,特异性为61.00%。GRP水平升高是ACS发生的独立保护因素(OR=0.334,95%CI:0.184~0.606)。与非MACE组相比,MACE组患者血清GRP水平明显降低(P<0.05)。低水平GRP组患者PCI术后MACE的发生风险明显高于高水平GRP组(P=0.022),且血清GRP水平升高是PCI术后MACE发生的独立保护因素(HR=0.347,95%CI:0.206~0.584)。血清GRP水平与ACS患者血清IL-1β(r=-0.271,P=0.003)、TNF-α(r=-0.481,P<0.001)、ICAM-1(r=-0.315,P=0.001)和VCAM-1(r=-0.279,P=0.002)水平均呈明显负相关。结论GRP在ACS患者血清中明显降低,可作为ACS诊断及预测PCI术后MACE发生风险的新型生物标志物。Objective To investigate the relationship between serum Gla-rich protein(GRP)levels and the risk of major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods 120 ACS patients admitted to our hospital from June 2020 to January 2022(ACS group)were selected as study subjects.They were divided into MACE group(22 cases)and non-MACE group(98 cases)according to the occurrence of MACE within 6 months after PCI.100 cases of healthy people who underwent physical examination in our hospital during the same period were selected as the control group.Clinical data of all subjects were collected.Serum GRP levels were measured by enzyme-linked immunosorbent assay and divided into low GRP group and high GRP group.ROC curves were plotted to evaluate the efficacy of serum GRP in diagnosing ACS.Logistic regression was used to analyse the risk factors affecting the occurrence of ACS.Kaplan-Meier method and Cox regression were used to analyse the predictive value of serum GRP for MACE.Results Serum GRP levels were significantly lower in patients in the ACS group compared with the control group(P<0.05).Serum GRP levels were significantly negatively correlated with both Gensini score and GRACE score in patients with ACS(P<0.05).The AUC of serum GRP for the diagnosis of ACS was 0.736(95%CI:0.668-0.804),with a sensitivity of 80.00%and a specificity of 61.00%.Elevated levels of GRP were an independent protective factor for the development of ACS(OR=0.334,95%CI:0.184-0.606,P<0.001).Serum GRP levels were significantly lower in patients in the MACE group compared to the non-MACE group(P<0.05).The risk of MACE after PCI was significantly higher in patients in the low-level GRP group than in the high-level GRP group(P=0.022),and the elevated serum GRP level was an independent protective factor for the occurrence of MACE after PCI(HR=0.347,95%CI:0.206-0.584,P<0.001).Serum GRP levels were significantly negatively correlated with serum IL-1β(r=-0.271,P=0.003),TNF-α

关 键 词：富含Gla蛋白 急性冠状动脉综合征 主要不良心血管事件 诊断价值 危险因素 

分 类 号：R543.3[医药卫生—心血管疾病]