血清Versican和ADAMTS4水平与急性冠状动脉综合征预后的关系  

Relationship between serum Versican and ADAMTS4 levels and prognosis in patients with acute coronary syndromes

作　　者：朱梦宇 高彦琳 戎李 成威 ZHU Mengyu;GAO Yanlin;RONG Li;CHENG Wei(Graduate School of Bengbu Medical University,Bengbu,Anhui,233030,China;Department of Cardiology,Anhui No2.Provincial People's Hospital)

机构地区：[1]蚌埠医科大学研究生院,安徽蚌埠233030 [2]安徽省第二人民医院心血管内科

出　　处：《临床心血管病杂志》2025年第1期55-60,共6页Journal of Clinical Cardiology

基　　金：安徽省高校自然科学研究项目(No:2023AH053377);安徽医科大学校科研基金项目(No:2021xkj117)。

摘　　要：目的:观察多能蛋白聚糖(Versican)及含Ⅰ型血小板反应蛋白基序列的解整合素样金属基质蛋白酶4(a disintegrin and metalloproteinase with thrombospondin motifs 4,ADAMTS4)在不同类型急性冠状动脉综合征(acute coronary syndrome,ACS)患者血清中的表达及其与临床预后的关系。方法:纳入因胸痛就诊于我院的300例患者,根据临床资料和冠状动脉(冠脉)造影结果分为不稳定型心绞痛组(UAP组,133例)、急性心肌梗死组(AMI组,100例)和非冠心病组(对照组,67例),检测所有患者血清Versican和ADAMTS4水平。对UAP和AMI两组患者进行平均18个月的随访,评估远期主要不良心血管事件(major adverse cardiovascular events,MACE)发生情况。根据是否发生MACE,将患者分为MACE组(45例)和非MACE组(178例),比较两组患者血清Versican和ADAMTS4水平。采用logistic回归分析筛选MACE发生的危险因素。采用ROC分析评估血清Versican和ADAMTS4水平对MACE发生的预测价值。结果:UAP组和AMI组血清Versican和ADAMTS4水平均明显高于对照组(均P<0.05)。MACE组患者Versican和ADAMTS4水平均高于非MACE组(均P<0.05)。多因素logistic回归分析显示,Versican(OR:1.028,95%CI:1.015~1.041,P<0.001)、ADAMTS4(OR:1.013,95%CI:1.007~1.018,P<0.001)水平和Gensini评分(OR:1.015,95%CI:1.003~1.026,P=0.013)是ACS患者发生MACE的危险因素。Versican、ADAMTS4及二者联合预测ACS患者发生MACE的ROC曲线下面积分别为0.772、0.752和0.863。结论:ACS患者血清Versican和ADAMTS4水平明显升高,对ACS患者MACE发生风险有一定的预测能力。Objective To evaluate the relationship between serum levels of Versican and A-disintegrin and metalloproteinase with thrombospondin motif 4(ADAMTS4)and clinical outcomes in patients with acute coronary syndrome(ACS).Methods This study enrolled 300 patients presenting with chest pain,who were classified into three groups based on clinical presentation and coronary angiography findings:unstable angina pectoris(UAP,n=133),acute myocardial infarction(AMI,n=100),and control(n=67).Serum Versican and ADAMTS4 levels were tested in all patients.Patients in the UAP and AMI groups were followed for a median of 18 months to assess the occurrence of major adverse cardiovascular events(MACE)in the long term.According to the occurrence of MACE,patients were divided into the MACE group(n=45)and the non-MACE group(n=178),and the serum Versican and ADAMTS4 levels were compared between the two groups.Logistic regression analysis was used to screen for risk factors of MACE.ROC analysis was used to evaluate the predictive value of serum Versican and ADAMTS4 levels for the occurrence of MACE.Results Serum Versican and ADAMTS4 levels were significantly elevated in the UAP and AMI groups than those in the control group(all P<0.05).Versican and ADAMTS4 levels were higher in the MACE group than those in the non-MACE group(both P<0.05).Multivariate logistic regression analysis showed that Versican(OR:1.028,95%CI:1.015-1.041,P<0.001),ADAMTS4(OR:1.013,95%CI:1.007-1.018,P<0.001),and Gensini score(OR:1.015,95%CI:1.003-1.026,P=0.013)were risk factors for MACE in patients with ACS.The area under the ROC curve for Versican,ADAMTS4,and their combination in predicting MACE in ACS patients was 0.772,0.752,and 0.863,respectively.Conclusion The levels of serum Versican and ADAMTS4 in ACS patients are significantly increased and demonstrate significant predictive value for the risk of MACE occurrence.

关 键 词：急性冠状动脉综合征 多能蛋白聚糖 解整合素样金属基质蛋白酶4 预后 

分 类 号：R541.4[医药卫生—心血管疾病]