血清心型脂肪酸结合蛋白、中性粒细胞明胶酶相关脂质运载蛋白和半乳糖凝集素-3水平与急性心肌梗死患者冠状动脉病变程度的相关性及其对患者预后的预测价值  

Correlation of serum heart type fatty acid binding protein,neutrophil gelatinase-associated lipocalin and galectin-3 levels with the severity of coronary artery lesions in patients with acute myocardial infarction and their predictive value for prognosis

作　　者：刘朏 杜洪洋 李晗 LIU Fei;DU Hongyang;LI Han(Department of Hypertension,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州大学附属郑州中心医院高血压科,河南郑州450000

出　　处：《新乡医学院学报》2025年第4期300-303,309,共5页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20210776)。

摘　　要：目的探讨血清心型脂肪酸结合蛋白(H-FABP)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、半乳糖凝集素-3(Gal-3)水平与急性心肌梗死(AMI)患者冠状动脉病变程度的相关性及其对患者预后的预测价值。方法选择2022年2月至2023年2月郑州大学附属郑州中心医院收治的85例行经皮冠状动脉介入术(PCI)治疗的AMI患者作为研究对象。根据术前冠状动脉病变SYNTAX评分将患者分为轻度组(n=26)、中度组(n=37)及重度组(n=22)。采用酶联免疫吸附法检测各组患者血清中H-FABP、NGAL、Gal-3水平;Spearman相关性分析H-FABP、NGAL、Gal-3水平与AMI患者冠状动脉病变程度的关系。术后随访1 a,记录患者随访期间心血管不良事件发生情况。绘制受试者操作特征(ROC)曲线评估血清H-FABP、NGAL、Gal-3水平对AMI患者预后的预测价值。结果轻度组、中度组、重度组患者的血清H-FABP、NGAL、Gal-3水平随着病情严重程度的升高而逐渐升高,两两比较差异均有统计学意义(P<0.05)。Spearman相关性分析结果显示,血清H-FABP、NGAL、Gal-3水平与冠状动脉病变严重程度均呈正相关(r=0.946、0.873、0.861,P<0.05)。轻、中、重度组患者心血管不良事件发生率分别为11.54%(3/26)、18.92%(7/37)、54.54%(12/22),重度组患者心血管不良事件发生率显著高于中度组和轻度组(χ^(2)=8.021、10.259,P<0.05),中度组与轻度组患者心血管不良事件发生率比较差异无统计学意义(χ^(2)=0.623,P>0.05)。ROC曲线结果显示,H-FABP、NGAL、Gal-3预测AMI患者预后的曲线下面积分别为0.803、0.785、0.720,灵敏度分别为81.60%、78.75%、76.30%,特异度分别为62.50%、60.50%、58.90%,三者联合预测AMI患者预后的曲线下面积、灵敏度、特异度分别为0.896、86.20%、72.50%。结论血清H-FABP、NGAL、Gal-3水平变化与AMI患者冠状动脉病变程度呈正相关,且三者联合检测对AMI患者的预后情况具有较高的预测价值。Objective To explore the correlation of serum levels of heart type fatty acid binding protein(H-FABP),neutrophil gelatinase-associated lipocalin(NGAL),and galectin-3(Gal-3)with the severity of coronary artery lesions in patients with acute myocardial infarction(AMI),and to analyze their value of predicting prognosis in patients.Methods A total of 85 AMI patients who underwent percutaneous coronary intervention(PCI)at Zhengzhou Central Hospital Affiliated to Zhengzhou University from February 2022 to February 2023 were selected as study subjects,and then they were divided into a mild group(n=26),a moderate group(n=37),and a severe group(n=22)according to the preoperative SYNTAX score of coronary artery lesions.The serum levels of H-FABP,NGAL,and Gal-3 in each group were measured by enzyme-linked immunosorbent assay.Spearman correlation analysis was made to investigate the relationship of H-FABP,NGAL,and Gal-3 levels with the severity of coronary artery lesions in AMI patients.The patients were followed up for one year after the operation,and the incidence of adverse cardiovascular events during the follow-up period was recorded.The receiver operating characteristic(ROC)curve was drawn to evaluate the value of serum H-FABP,NGAL,and Gal-3 levels for predicting the prognosis of AMI patients.Results The serum levels of H-FABP,NGAL,and Gal-3 were the highest in the severe group,followed by those in the moderate and mild groups successively(P<0.05).Spearman correlation analysis showed that the serum levels of H-FABP,NGAL,and Gal-3 were positively correlated with the severity of coronary artery lesions(r=0.946,0.873,0.861;P<0.05).The incidence of adverse cardiovascular events in the mild,moderate,and severe groups was 11.54%(3/26),18.92%(7/37),and 54.54%(12/22),respectively.The incidence of adverse cardiovascular events in the severe group was significantly higher than that in the mild group and moderate group(χ^(2)=10.259,8.021;P<0.05).There were no significant differences in the incidence of adverse cardiovascular eve

关 键 词：心型脂肪酸结合蛋白 中性粒细胞明胶酶相关脂质运载蛋白 半乳糖凝集素-3 急性心肌梗死 冠状动脉病变 

分 类 号：R366.5[医药卫生—病理学]