血清血管生成素样蛋白2、补体C1q肿瘤坏死因子相关蛋白5对主动脉夹层患者预后的预测价值  

Prognostic value of serum angiopoietin-like protein-2 and and complement C1q tumor necrosis factor-related proteins 5 in patients with aortic dissection

作　　者：李娟[1] 董瑞莹 赵颖辉 Li Juan;Dong Ruiying;Zhao Yinghui(Department of Cardiovascular Surgery,the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine,Xi'an 710061,ShaanXi,China;the First Ward of Cardiovascular Disease,Xi'an Fifth Hospital,Xi'an 710082,Shaanxi,China)

机构地区：[1]西安交通大学医学院第一附属医院心血管外科,陕西西安710061 [2]西安市第五医院心血管一病区,陕西西安710082

出　　处：《血管与腔内血管外科杂志》2025年第3期306-311,共6页Journal of Vascular and Endovascular Surgery

基　　金：陕西省重点研发计划项目(2023-YBSF-046)。

摘　　要：目的探讨血清血管生成素样蛋白2(ANGPTL2)、补体C1q肿瘤坏死因子相关蛋白5(CTRP5)表达水平及二者联合对主动脉夹层患者预后的预测价值。方法收集2019年11月至2021年1月西安交通大学医学院第一附属医院收治的128例急性A型主动脉夹层患者的临床资料设为病患组,同时收集体检健康人群130例为正常组。采用酶联免疫吸附法(ELISA)测定血清ANGPTL2、CTRP5表达水平,使用K-M法绘制主动脉夹层患者生存曲线,Pearson法分析ANGPTL2、CTRP5表达与患者术后指标的相关性,采用多因素Logistic回归模型分析影响主动脉夹层患者预后的因素,绘制受试者工作特征(ROC)曲线分析ANGPTL2、CTRP5对主动脉夹层患者预后的预测价值。结果病患组血清ANGPTL2、CTRP5表达水平均高于正常组,差异均有统计学意义(P﹤0.05)。病患组患者死亡31例,纳入预后不良组;生存97例,纳入预后良好组,病患组患者术后3年总生存率为75.78%(97/128)。根据ANGPTL2、CTRP5表达水平不同将其分为ANGPTL2高表达组(n=62,≥10.75 pg/ml)与低表达组(n=66,﹤10.75 pg/ml),CTRP5高表达组(n=65,≥44.93 pg/ml)与低表达组(n=63,﹤44.93 pg/ml)。ANGPTL2、CTRP5高表达组患者累积生存率分别为64.5%(40/62)、66.2%(43/65),与ANGPTL2、CTRP5低表达组患者的86.4%(57/66)、85.7%(54/63)比较,差异均有统计学意义(P﹤0.05)。预后不良组患者血清ANGPTL2、CTRP5表达水平均高于预后良好组患者(P﹤0.05)。预后不良组患者首次下床活动时间、重症加强护理病房(ICU)住院天数、总住院天数均长于预后良好组患者(P﹤0.05)。病患组患者血清ANGPTL2、CTRP5水平均与术后首次下床活动时间、ICU住院天数、总住院天数呈正相关(P﹤0.05)。多因素分析结果显示,ANGPTL2、CTRP5均是影响主动脉夹层患者预后不良的危险因素(P﹤0.05)。血清ANGPTL2、CTRP5二者联合预测的AUC为0.975(95%CI:0.949~1.000),灵敏度为87.10%,特异度为96.90%。结论�Objective To investigate the expression levels of serum angiopoietin-like protein 2(ANGPTL2)and complement C1q/tumor necrosis factor-associated protein 5(CTRP5)and the predictive value of their combination in the prognosis of patients with aortic dissection.Method Clinical data of 128 patients with acute type A aortic dissection admitted to the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine from November 2019 to January 2021 were collected as the patient group,and 130 healthy people were collected as the normal group.The expression levels of serum ANGPTL2 and CTRP5 were measured by enzyme-linked immunosorbent assay(ELISA),the survival curve of patients with aortic dissection was plotted by K-M method,and the correlation between ANGPTL2 and CTRP5 expression and postoperative indicators of patients were analyzed by Pearson method.Multivariate Logistic regression model was used to analyze the influencing factors for the prognosis of patients with aortic dissection,the receiver operator characteristic(ROC)curve was drawn to analyze the predictive value of ANGPTL2 and CTRP5 for the prognosis of patients with aortic dissection.Result The expression levels of ANGPTL2 and CTRP5 in the patient group were higher than those in the normal group,the differences were statistically significant(P<0.05).In the patient group,31 patients died and were included in the poor prognosis group.In the patient group,the overall survival rate was 75.78%(97/128)after 3 years.According to the different expression levels of ANGPTL2 and CTRP5,they were divided into ANGPTL2 high expression group(n=62,≥10.75 pg/ml)and low expression group(n=66,<10.75 pg/ml),CTRP5 high expression group(n=65,≥44.93 pg/ml)and low expression group(n=63,<44.93 pg/ml).The cumulative survival rate of patients in ANGPTL2 and CTRP5 high expression group were 64.5%(40/62)and 66.2%(43/65)respectively,compared with ANGPTL2 and CTRP5 low expression group of 86.4%(57/66)and 85.7%(54/63)respectively,the differences were statistically significant(P

关 键 词：主动脉夹层 血管生成素样蛋白2 C1q肿瘤坏死因子相关蛋白5 预后 

分 类 号：R543[医药卫生—心血管疾病]