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血清血管生成素样蛋白2及分泌型卷曲相关蛋白5预测急性冠状动脉综合征患者术后冠状动脉慢血流的价值

Value of serum angiopoietin-like protein 2 and secreted frizzled-related protein 5 in predicting postoperative coronary slow flow in patients with acute coronary syndrome

    摘要
  • 摘要:
    目的 探讨血清血管生成素样蛋白2(ANGPTL2)、分泌型卷曲相关蛋白5(SFRP5)水平预测急性冠状动脉综合征(ACS)患者经皮冠状动脉介入术(PCI)术后冠状动脉慢血流(CSF)的价值。
    方法 选取行PCI的182例ACS患者为研究对象，根据患者PCI术后是否发生CSF分为CSF组42例和血流正常组140例。采用酶联免疫吸附(ELISA)法检测ACS患者PCI术前血清ANGPTL2、SFRP5水平。采用Pearson相关性分析探讨CSF组患者PCI术前血清ANGPTL2与SFRP5水平的相关性。采用多因素Logistic回归分析探讨ACS患者PCI术后CSF发生的危险因素; 采用受试者工作特征(ROC)曲线评价血清ANGPTL2、SFRP5水平对ACS患者PCI术后发生CSF的预测价值。
    结果 CSF组患者PCI术前血清ANGPTL2水平为(3.48±0.66) ng/mL, 高于血流正常组的(2.80±0.51) ng/mL, 差异有统计学意义(P < 0.05); CSF组患者PCI术前血清SFRP5水平为(14.85±4.04) ng/mL, 低于血流正常组的(22.12±4.69) ng/mL, 差异有统计学意义(P < 0.05)。CSF组患者PCI术前血清ANGPTL2与SFRP5水平呈显著负相关(r=-0.661, P < 0.001)。PCI术前血清ANGPTL2高水平、SFRP5低水平是ACS患者PCI术后CSF发生的危险因素。ANGPTL2、SFRP5联合预测PCI术后CSF的ROC曲线的曲线下面积(AUC)显著大于ANGPTL2单独预测的AUC(Z=2.206, P=0.014)及SFRP5单独预测的AUC(Z=1.696, P=0.045)。
    结论 血清ANGPTL2、SFRP5水平是PCI术后CSF发生的影响因素, ACS患者术前ANGPTL2水平升高、SFRP5水平降低与PCI术后CSF的发生有关，两者联合检测对ACS患者PCI术后发生CSF具有预测价值。

     

    Abstract:
    Objective To explore the value of serum angiopoietin-like protein 2 (ANGPTL2) and secreted frizzled-related protein 5 (SFRP5) levels in predicting coronary slow flow (CSF) after percutaneous coronaryintervention (PCI) in patients with acute coronary syndrome (ACS).
    Methods A total of 182 patients with ACS who underwent PCI were regarded as the research subjects. According to whether the patients developed CSF after PCI, they were grouped into CSF group (42 cases) and normal blood flow group (140 cases). Enzyme-linked immunosorbent assay (ELISA) was performed to detect the levels of serum ANGPTL2 and SFRP5 in ACS patients before PCI. Pearson correlation was performed to analyze the correlation between the levels of serum ANGPTL2 and SFRP5 in the CSF group before PCI. Multivariate Logistic regression was performed to analyze the risk factors of CSF after PCI in ACS patients; receiver operating characteristic (ROC) curve was performed to evaluate the predictive value of levels of serum ANGPTL2 and SFRP5 for CSF in patients with ACS after PCI.
    Results The level of serum ANGPTL2 in the CSF group was (3.48±0.66) ng/mL, which was significantly higher than (2.80±0.51) ng/mL in the normal blood flow group (P < 0.05); the level of serum SFRP5 in the CSF group was (14.85±4.04) ng/mL, which was significantly lower than (22.12±4.69) ng/mL in the normal blood flow group (P < 0.05). There was a significant negative correlation between serum ANGPTL2 and SFRP5 before PCI in CSF group (r=-0.661, P < 0.001). High level of serum ANGPTL2 and low level of SFRP5 before PCI were risk factors for CSF in patients with ACS after PCI. The area under the ROC curve (AUC) of ANGPTL2 and SFRP5 in predicting CSF after PCI was significantly greater than that predicted by ANGPTL2 alone (Z=2.206, P=0.014) and by SFRP5 alone (Z=1.696, P=0.045).
    Conclusion Serum ANGPTL2 and SFRP5 levels are the factors influencing the occurrence of CSF after PCI. The increased level of ANGPTL2 and decreased level of SFRP5 before and after PCI in patients with ACS are associated with the occurrence of CSF after PCI. The combined detection has predictive value for the occurrence of CSF after PCI in patients with ACS.

     

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