血清KLK1、SOX6水平与急性冠状动脉综合征患者经皮冠状动脉介入治疗术后预后的关系OACSTPCD
Relationship between serum levels of kallikrein 1,sex-determining region of Y-related high-mobility-group box 6,and prognosis after percutaneous coronary intervention in patients with acute coronary syndrome
目的 探讨组织激肽释放酶 1(KLK1)、性别决定区Y框相关高迁移率族蛋白 6(SOX6)与急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)后预后的关系.方法 选择 2019 年 1 月至 2020 年 11 月期间河北大学附属医院收治的ACS患者 122 例作为研究对象,根据 1 年内是否发生主要不良心血管事件(MACE)分为预后良好组(96 例)和预后不良组(26 例).采用酶联免疫吸附法检测血清KLK1、SOX6 水平;采用受试者工作特征(ROC)曲线评估KLK1、SOX6 对ACS患者PCI后MACE的预测价值;Kaplan-Meier法比较不同KLK1、SOX6 水平ACS患者的预后情况;Cox多因素回归分析ACS患者预后的影响因素.结果 预后不良组血清超敏C反应蛋白(hs-CRP)水平高于预后良好组(t=13.311,P<0.05),血清KLK1、SOX6 水平均低于预后良好组(t=5.855、6.205,P<0.05).预后良好组植入支架数低于预后不良组(t=2.369,P<0.05).ROC曲线显示,KLK1、SOX6 对预后预测的AUC为 0.798、0.760,两者联合对预后预测的AUC为 0.909,高于单独预测(Z=2.925、3.639,P<0.05),敏感度、特异度分别为 90.62%、76.92%.Kaplan-Meier分析显示,KLK1 低表达ACS患者MACE的发生率高于KLK1 高表达者(Log rank χ2=8.674,P<0.01),SOX6 低表达ACS患者MACE的发生率高于SOX6高表达者(Log rank χ2=23.539,P<0.01).Cox回归分析显示,KLK1、SOX6 均是ACS患者PCI治疗后发生MACE的保护因素(HR=0.725、0.618,P<0.05).结论 KLK1、SOX6 在预后不良的PCI后ACS患者血清中表达均降低,两者联合对MACE的发生具有一定的预测价值,临床可用于ACS患者PCI术后是否发生MACE的早期评估.
Objective To investigate the relationship between kallikrein 1(KLK1),sex-determining region of Y-related high-mobility-group box 6(SOX6),and the prognosis after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods A total of 122 ACS patients admitted to the Affiliated Hospital of Hebei University from January 2019 to November 2020 were selected as the research subjects.Based on the occurrence of major adverse cardiovascular events(MACE)within 1 year,patients were divided into a good prognosis group(96 cases)and a poor prognosis group(26 cases).Serum levels of KLK1 and SOX6 were detected by enzyme-linked immunosorbent assay.Receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of KLK1 and SOX6 for MACE after PCI.Kaplan-Meier analysis was introduced to compare the prognosis of ACS patients with different KLK1 and SOX6 levels.Cox multivariate regression was performed to analyze the prognostic factors in patients with ACS.Results The serum hypersensitive C-reactive protein(hs-CRP)level in the poor prognosis group was higher than that in the good prognosis group(t=13.311,P<0.05),and the serum KLK1 and SOX6 levels were significantly lower than those in the good prognosis group(t=5.855,6.205;P<0.05).The number of implanted stents in the good prognosis group was lower than that in the poor prognosis group(t=2.369,P<0.05).The ROC curve showed that the AUCs of KLK1 and SOX6 for predicting prognosis were 0.798 and 0.760,respectively.Their combined AUC was 0.909,which was greatly higher than those of single predictions(Z=2.925,3.639;P<0.01),with sensitivity and specificity of 90.62%and 76.92%,respectively.Kaplan-Meier analysis showed that the incidence of MACE in ACS patients with low KLK1 expression was higher than that in patients with high KLK1 expression(Log rank χ2=8.674,P<0.01),and the same trend was observed for SOX6(Log rank χ2=23.539,P<0.01).Cox regression analysis showed that both KLK1 and SOX6 were protective factors for MACE in ACS patients after PCI(HR=0.725,0.618;P<0.05).Conclusion The expression levels of KLK1 and SOX6 are decreased in the serum of ACS patients with poor prognosis after PCI.Their combination has certain predictive value for the occurrence of MACE,and can be clinically used for the early assessment of the occurrence of MACE in ACS patients after PCI.
韩思梁;孔繁昌;张伊超;桑大森;田晰晰;解俊敏
071000 保定,河北大学附属医院心血管内科071000 河北保定脉管炎医院介入科071028 河北省保定市第一中心医院心血管内科
组织激肽释放酶1性别决定区Y框相关高迁移率族蛋白6急性冠状动脉综合征经皮冠状动脉介入治疗预后
Kallikrein 1Sex-determining region of Y-related high-mobility-group box 6Acute coronary syndromePercutaneous coronary interventionPrognosis
《心脑血管病防治》 2024 (005)
8-12 / 5
保定市科技计划自筹经费项目(2241ZF296)
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