文章摘要
张伟伟,程思源,张 苑,孟浩宇,陈磊磊.脂肪因子Vaspin表达在急性冠脉综合征诊断及预后评估中的作用[J].南京医科大学学报,2019,(2):224~227
脂肪因子Vaspin表达在急性冠脉综合征诊断及预后评估中的作用
The role of Vaspin expression in the diagnostic and prognostic evaluation of acute coronary syndrome
投稿时间:2018-08-17  
DOI:10.7655/NYDXBNS20190213
中文关键词: Vaspin  急性冠脉综合征  心肌肌钙蛋白T  B型尿钠肽前体
英文关键词: vaspin  acute coronary syndrome  cardiac troponin T  N⁃terminal pro⁃brain natriuretic peptide
基金项目:江苏省六大人才高峰资助项目
作者单位
张伟伟 南京医科大学第一附属医院心血管内科江苏 南京 210029 
程思源 南京医科大学第一附属医院心血管内科江苏 南京 210029 
张 苑 南京医科大学第一附属医院心血管内科江苏 南京 210029 
孟浩宇 南京医科大学第一附属医院心血管内科江苏 南京 210029 
陈磊磊 南京医科大学第一附属医院心血管内科江苏 南京 210029 
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中文摘要:
      目的:测定内脏脂肪特异性丝氨酸蛋白酶抑制剂(vaspin)、心肌肌钙蛋白T(cardiac troponin T,cTnT)以及 B型尿钠肽前体(N?terminal pro?brain natriuretic peptide,NT?pro?BNP)在急性冠脉综合征组(acute coronary syndrome,ACS)、稳定性冠心病组和对照组中的表达水平,比较它们在各组的差异,为ACS临床诊断及预后评估提供新依据。方法:随机选取经冠状动脉造影术诊断明确ACS 158例,稳定性冠心病80例,非冠心病90例(对照组)。通过酶联免疫吸附实验法检测入组患者血清Vaspin浓度,同时检测cTnT和NT?pro?BNP的表达水平。采用单因素方差分析法比较ACS组、稳定性冠心病组和对照组之间Vaspin、cTnT、NT?pro?BNP的表达水平差异。随访术后2年内心源性死亡、心源性再入院以及再血管化治疗的发生情况,采用多因素Logistic回归分析法评估Vaspin表达水平与心血管不良预后的差异,最终综合评价Vaspin表达水平在ACS早期诊断及预后评估中的作用。结果:Vaspin表达:ACS组<稳定性冠心病组<对照组,差异具有统计学意义(P < 0.01);cTnT表达:ACS组>稳定性冠心病组>对照组,差异具有统计学意义(P < 0.01);NT?pro?BNP表达:ACS组>稳定性冠心病组>对照组,差异具有统计学意义(P < 0.01)。Vaspin浓度与NT?pro?BNP和cTnT的水平呈显著负相关。Vaspin表达水平越低,发生心源性死亡、心源性再入院以及再血管化等不良事件的风险越高。结论:Vaspin在ACS中的表达水平显著低于稳定性冠心病和非冠心病患者,且与NT?pro?BNP和cTnT呈负相关。Vaspin是ACS的独立危险因素,Vaspin的表达水平越低则患者冠心病程度越重且预后越差。
英文摘要:
      Objective:Observing the expression of visceral fat?specific serine protease inhibitor(Vaspin),cardiac troponin T(cTnT)and N?terminal pro?brain natriuretic peptide(NT?pro?BNP)in acute coronary syndrome(ACS),stable coronary heart disease and control to provide new basis of Vaspin for clinical diagnostic and prognostic evaluation of ACS. Methods:A total of 158 patients with ACS,80 patients with stable coronary heart disease and 90 patients without coronary heart disease were included. The expression of Vaspin was detected by enzyme?linked immunosorbent assay,while the levels of cTnT and NT?pro?BNP were detected at the same time. The expression levels of Vaspin,cTnT and NT?pro?BNP were analyzed and compared in three groups by one?way ANOVA. A 2?year follow?up of clinical outcomes including cardiac death,rehospitalization and revascularization was conducted and logistic analysis was used to evaluate the relationship between Vaspin level and clinical prognosis. Results:The results showed significant difference of Vaspin,cTnT and NT?pro?BNP among three groups(P < 0.01). The expression level of Vaspin was lowest in ACS group and highest in control group,while the expression level of cTnT and NT?pro?BNP were highest in ACS group and lowest in control group. There was significant negative correlations between Vaspin and NT?pro?BNP or cTnT. Furthermore,lower expression level of Vaspin indicated higher risk of cardiovascular adverse events,such as cardiac death,rehospitalization and revascularization. Conclusion:The expression level of Vaspin in ACS was significantly lower than that in stable and non?coronary heart disease,which was negatively correlated with NT?pro?BNP and cTnT. Vaspin is an independent risk factor for ACS,and the lower expression level of Vaspin,the worse prognosis of patients.
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