摘要
目的探讨血管生成素样蛋白1(Angpt1)、血管生成素样蛋白2(Angpt2)及高敏肌钙蛋白T(hs-cTnT)预测行经皮冠脉介入治疗(PCI)心绞痛患者心血管不良事件(MACE)的价值。方法收集2015年3月~2018年5月宜宾市第二人民医院收治行PCI治疗的123例心绞痛患者,比较不同分级患者血清Angpt1、Angpt2及hs-cTnT的差异;按随访1年是否发生MACE分组,筛选心绞痛发生MACE危险因素,分析以上参数对PCI治疗心绞痛发生MACE的预测价值及三者之间相关关系。结果随心绞痛病情分级的上升,血清Angpt2、hs-cTnT水平上升,Angpt1降低(P<0.05);MACE组血清Angpt2、hs-cTnT水平高于非MACE组,Angpt1水平低于非MACE组(P<0.05);MACE组左室射血分数(LVEF)<50%、氨基末端脑钠肽前体(NT-proBNP)≥500 pg/mL、心绞痛分级为Ⅲ级比例高于非MACE组(P<0.05);Angpt2、hs-cTnT、LVEF、NT-proBNP、心绞痛分级均为PCI术后发生MACE的危险因素(P<0.05);Angpt2预测PCI术后发生MACE约登指数最大时敏感度、特异性分别为95.65%、79.00%;hs-cTnT约登指数最大时敏感度、特异性分别为73.91%、89.00%;Angpt1约登指数最大时敏感度、特异性分别为60.87%、82.00%;Angpt2与Angpt1呈负相关(P<0.05),与hs-cTnT呈正相关(P<0.05),Angpt1与hs-cTnT呈负相关(P<0.05)。结论不稳定型心绞痛行PCI术后MACE发生与Angpt1、Angpt2、hs-cTnT浓度变化有关;Angpt2、hs-cTnT对不稳定型心绞痛PCI术后MACE发生有较高的预测价值,而Angpt1预测价值有限。
Objective To explore the value of angiopoietin-like protein 2(Angpt2),angiopoietin-like protein 1(Angpt1)and high-sensitivity troponin T(hs-cTnT)in predicting major adverse cardiovascular events(MACE)in angina patients undergoing percutaneous coronary intervention(PCI).Methods A total of 123 angina patients underwent PCI in Yibin Second People's Hospital from March 2015 to May 2018 were enrolled.Serum Angpt2,Angpt1 and hs-cTnT were compared among patients with different grades of angina.They were grouped according to the occurrence of MACE during the 1-year follow-up.Risk factors for MACE were screened.The predictive value of above parameters for MACE in angina patients undergoing PCI,and the correlation among the three indicators were analyzed.Results With the increase of the grade of angina,levels of serum Angpt2 and hs-cTnT increased,while the Angpt1 level decreased(P<0.05).The levels of serum Angpt2 and hs-cTnT in MACE group were higher than those in non-MACE group,while the Angpt1 level was lower than non-MACE group(P<0.05).The proportions of left ventricular ejection fraction(LVEF)lower than 50%,N terminal pro B type natriuretic peptide(NT-proBNP)not higher than 500 pg/mL and grade III angina in MACE group were higher than those in non-MACE group(P<0.05).Angpt2,hs-cTnT,LVEF,NT-proBNP and angina grading were all risk factors for MACE after PCI(P<0.05).When the Youden index of Angpt2 for predicting MACE after PCI was the largest,the sensitivity and specificity were 95.65%and 79.00%.When the Youden index of hs-cTnT was the largest,the sensitivity and specificity were 73.91%and 89.00%.When the Youden index of Angpt1 was the largest,the sensitivity and specificity were 60.87%and 82.00%.Angpt2 was negatively correlated with Angpt1(P<0.05),but positively correlated with hs-cTnT(P<0.05).Angpt1 was negatively correlated with hs-cTnT(P<0.05).Conclusion The occurrence of MACE in patients with unstable angina after PCI is related to changes in levels of Angpt2,Angpt1 and hs-cTnT.Angpt2 and hs-cTnT are of great value for predicting MACE after PCI while the predictive value of Angpt1 is limited.There is a correlation among the expression of the three indicators.
作者
邓丽丽
胡容
刘艳
李岩辉
陈天艺
DENG Lili;HU Rong;LIU Yan;LI Yanhui;CHEN Tianyi(Department of Clinical Laboratory,Yibin Second People's Hospital,Yibin 644000,Sichuan,China;Southwestern Medical University,Luzhou 646000,Sichuan,China;Department of Laboratory Medicine,Jiang'an County Traditional Chinese Medicine Hospital,Yibin 644200,Sichuan,China)
出处
《西部医学》
2020年第7期1076-1080,共5页
Medical Journal of West China
基金
四川省卫计委应用基础研究课题(17PJ567)。
