目的 探讨肌红蛋白(Myo)、生长停滞特异性蛋白6(Gas6)、SRY相关高迁移率族蛋白9(SOX9)在急性心肌梗死(AMI)患者中的表达意义,同时将患者预后经皮冠状动脉介入治疗(PCI)联合检测评估价值.方法 选择2020年1月至2021年6月期间接收的AMI患者,共计166例,并将其纳入研究组,同时选取健康志愿者,将其纳入对照组,共计90例.酶联免疫吸附法测定血清Myo、Gas6水平,SOX9 mRNA分离试剂盒提取RNA检测;根据患者住院期间是否发生心血管不良事件(MACCE)将研究组患者分为MACCE组和非MACCE组;对比研究组和对照组Myo、Gas6、SOX9 mRNA表达情况;对比Myo、Gas6、SOX9 mRNA在AMI患者PCI术前后中表达情况;单因素/多因素分析MACCE组和非MACCE组资料临床差异;分析Myo、Gas6、SOX9 mRNA联合对AMI预后评估价值.结果 相较于对照组,研究组Myo和Gas6明显较高,SOX9 mRNA表达明显较低(P＜0.05);术后,研究组患者Myo、Gas6表达明显降低,SOX9 mRNA明显升高(P＜0.05);MACCE组Myo和Gas6明显高于非MACCE组,SOX9 mRNA表达明显低于非MACCE组(P＜0.05).Logistic回归模型结果显示年龄大、术后出血、Myo和Gas6表达高、SOX9 mRNA表达低是影响经PCI治疗AMI患者发生MACCE独立危险因素(P＜0.05).Myo、Gas6、SOX9 mRNA联合评估AMI预后受试者工作特征(ROC)曲线下面积为0.936,具有较高的特异度以及敏感度,且显著高于单独Myo、Gas6、SOX9 mRNA检测ROC曲线下面积为0.706、0.696和0.711(Z=2.261,P＜0.05).结论 对于AMI患者而言,其Myo和Gas6表达明显较高,SOX9 mRNA表达明显降低,而经PCI术治疗可有效改善患者Myo、Gas6和SOX9 mRNA水平;三者联合对PCI术后发生MACCE具有明显评估作用,尽早为患者提供诊疗方案,值得在临床推广应用.
Objective To investigate the expression significance of myoglobin(Myo),growth arrest-specific protein 6(Gas6),and SRY-related high-mobility group box 9(SOX9)in patients with acute myocardial infarction(AMI)and evaluate their combined detection value for prognosis assessment after percutaneous coronary intervention(PCI).Methods A total of 166 patients with AMI admitted between January 2020 and June 2021 were included in the study group,and 90 healthy volunteers were recruited as the control group.Serum levels of Myo and Gas6 were measured by enzyme-linked immunosorbent assay,and SOX9 mRNA was detected using the SOX9 mRNA isolation kit.Patients in the study group were divided into MACCE group and non-MACCE group based on the occurrence of major adverse cardio-vascular and cerebrovascular events(MACCE)during hospitalization.The expression of Myo,Gas6,and SOX9 mRNA was compared between the study and control groups,as well as before and after PCI in AMI patients.Clinical differences between the MACCE and non-MACCE groups were analyzed using univariate/multivariate analysis.The prognostic value of combined Myo,Gas6,and SOX9 mRNA detection for AMI prognosis was assessed.Results Compared with the con-trol group,the study group showed significantly higher levels of Myo and Gas6,and lower expression of SOX9 mRNA(P＜0.05).After PCI,patients in the study group exhibited significantly decreased expression of Myo and Gas6,and in-creased expression of SOX9 mRNA(P＜0.05).The MACCE group had significantly higher levels of Myo and Gas6 and lower expression of SOX9 mRNA compared to the non-MACCE group(P＜0.05).Logistic regression analysis showed that age,postoperative bleeding,Myo,Gas6,and SOX9 mRNA were independent risk factors affecting the occurrence of MACCE in AMI patients treated with PCI(P＜0.05).The area under the ROC curve for combined assessment of AMI prognosis using Myo,Gas6,and SOX9 mRNA was 0.936,with higher specificity and sensitivity compared to individual detection of Myo,Gas6,and SOX9 mRNA(0.706,0.696,and 0.711,respectively;Z=2.261,P＜0.05).Conclu-sion For patients with AMI,higher expression of Myo and Gas6 and lower expression of SOX9 mRNA were observed,and PCI treatment effectively improved the levels of Myo,Gas6,and SOX9 mRNA.Combined detection of these three bio-markers has a significant predictive role for MACCE after PCI,facilitating early diagnosis and treatment decision-making for patients,and warrants clinical application.
郭会敏;安静霞;李辉
邯郸市中心医院心血管内科(河北邯郸 056000)
临床医学
肌红蛋白;生长停滞特异性蛋白6;SRY相关高迁移率族蛋白;急性心肌梗死;表达意义;预后;诊断价值
myoglobin;growth arrest-specific protein 6;SRY-related high mobility group protein;acute myo-cardial infarction;expression significance;prognosis;diagnostic value
《广东医学》 2024 (003)
329-334 / 6
河北省医学科学研究课题(20220535)
10.13820/j.cnki.gdyx.20231348
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