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Received:November 02, 2019 Published Online:July 20, 2020
Received:November 02, 2019 Published Online:July 20, 2020
中文摘要: 目的 探讨急性冠脉综合征(ACS)患者血浆可溶性低密度脂蛋白受体相关蛋白1(sLRP-1)、血清调节活化正常T细胞表达和分泌因子(RANTES)与全球急性冠状动脉事件注册(GRACE)评分的关系,进一步分析其对30 d内发生主要不良心血管事件(MACE)的预测价值。
方法 选取2018年6月至11月收治的ACS患者120例,ELISA法测血浆sLRP-1和血清RANTES水平,记录GRACE评分及危险分层(>140分为GRACE高危组,109~140分为中危组,<109分为低危组)。sLRP-1(μg/ml)水平呈偏态分布,取lg转换后呈正态分布,以lg sLRP-1(μg/ml)进行统计分析。根据lg sLRP-1、RANTES中位数值分别分为高lg sLRP-1组(>0.54 μg/ml)和低lg sLRP-1组(≤0.54 μg/ml)、高RANTES组(>125.47 pg/ml)和低RANTES组(≤125.47 pg/ml)。分析sLRP-1、RANTES水平与GRACE评分的关系及对预后的评估。
结果 GRACE评分高危组lg sLRP-1、RANTES水平分别高于中危组和低危组(P均<0.05)。高lg sLRP-1组、高RANTES组GRACE评分分别高于低lg sLRP-1组、低RANTES组(P均<0.01)。ACS患者血浆lg sLRP-1、血清RANTES水平与GRACE评分呈正相关(r=0.460,P<0.05;r=0.626,P<0.05)。对于ACS 30 d发生MACE的患者,lg sLRP-1、RANTES、GRACE评分以及三者联合预测的ROC曲线下面积分别为0.875、0.787、0.820和0.924,以三者联合为高(P<0.05)。
结论 sLRP-1、RANTES水平与ACS相关,sLRP-1、RANTES联合GRACE评分能更好地反映ACS患者的危险分层。
Abstract:Objective To investigate the relationship between plasma soluble low-density lipoprotein receptor-related protein-1(sLRP-1),serum regulated upon activation normal T cell expressed and secreted (RANTES) and Global Registry of Acute Coronary Events(GRACE) score in the patients with acute coronary syndrome (ACS) and further analyze their impacts on 30 d major adverse cardiac event(MACE).
Methods A total of 120 ACS patients were selected,in whom plasma sLRP-1 and serum RANTES levels were detected by ELISA.Based on the risk assessment and stratification of GRACE scores,the patients were divided into high-risk group(GRACE score>140),medium-risk group(109-140) and low-risk group(<109).The statistical analysis was carried out with lg sLRP-1(μg/ml) in a normal distribution after lg conversion.According to the median value of lg sLRP-1 and RANTES,the patients were divided into high lg sLRP-1 group (>0.54 μg/ml),low lg sLRP-1 group (≤0.54 μg/ml),and high RANTES group (>125.47 pg/ml),low RANTES group (≤125.47 pg/ml),respectively.The associations of sLRP-1 and RANTES levels with GRACE scores and prognosis were analyzed and evaluated.
Results The levels of lg sLRP-1 and RANTES were significantly elevated in high-risk group compared with those in medium-risk group and low-risk group (all P<0.05).GRACE scores in high lg sLRP-1 group and high RANTES group were statistically higher than those in low lg sLRP-1 group and low RANTES group,respectively(all P<0.01).GRACE score was positively correlated with lg sLRP-1 and RANTES levels,respectively(r=0.460,P<0.05;r=0.626,P<0.05).In terms of lg sLRP-1,RANTES,GRACE score and the combination of the three predicting 30 d MACE,the area under the ROC curve(AUC) were 0.875,0.787,0.820 and 0.924,respectively,and AUC of the combination of three was the highest(P<0.05).
Conclusions The sLRP-1 and RANTES are associated with the progress of ACS.Detection of sLRP-1 and RANTES combined with GRACE scores can better reflect the risk stratification of ACS patients.
keywords: Soluble low-density lipoprotein receptor-related protein-1 Regulated upon activation normal T cell expressed and secreted Global Registry of Acute Coronary Eevents score Acute coronary syndrome Prognosis
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基金项目:河北省政府资助专科带头人培养项目(361008);承德市科学技术与发展计划项目(201801A055)
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