冠心病患者PCI术前血清CgA、GDF11、FDX1水平与术后MACE的关系OA
Relationship between serum CgA,GDF11 and FDX1 levels before PCI and postoperative major adverse cardiovascular events in patients with coronary heart disease
目的 探讨冠心病(CHD)患者经皮冠状动脉介入治疗(PCI)术前血清嗜铬粒蛋白 A(CgA)、生长分化因子11(GDF11)、铁氧还蛋白1(FDX1)水平与术后主要不良心血管事件(MACE)的关系.方法 选取2021年10月至2023年10月该院收治的153例CHD患者为研究对象.PCI术后对患者进行 6个月随访,依据随访期间 MACE发生情况,将患者分为 MACE组和非 MACE组.采用酶联免疫吸附试验(ELISA)检测血清CgA、GDF11、FDX1水平;采用多因素Logistic回归分析CHD患者PCI术后发生 MACE的影响因素;绘制受试者工作特征(ROC)曲线分析血清CgA、GDF11、FDX1单独及3项联合对CHD患者PCI术后发生 MACE的预测效能.结果 与非 MACE组相比,MACE组纽约心脏病协会(NYHA)心功能分级Ⅱ～Ⅲ级比例、多支血管病变比例及血清CgA水平较高,血清GDF11、FDX1水平较低,差异均有统计学意义(P<0.05).多因素Logistic回归分析结果显示,血清CgA水平升高、NYHA心功能分级Ⅱ～Ⅲ级、多支血管病变均是CHD患者PCI术后发 生 MACE的危险因素(P<0.05);血清 GDF11、FDX1水平升高均是 CHD 患者 PCI术后发生MACE的保护因素(P<0.05).血清CgA、GDF11、FDX1单独及3项联合预测CHD患者术后发生 MACE的曲线下面积(AUC)分别为0.863、0.872、0.757、0.962,3项联合预测的 AUC大于血清CgA(Z=3.619,P<0.001)、GDF11(Z=3.209,P=0.001)、FDX1(Z=4.978,P<0.001)单独预测.结论 CHD患者PCI术后发生 MACE的CHD患者术前血清CgA水平升高,而血清GDF11、FDX1水平降低;血清CgA、GDF11、FDX1联合检测对PCI术后 MACE的预测价值更高,可为临床早期筛查高危人群提供参考.
Objective To explore the relationship between preoperative serum chromogranin A(CgA),growth differentiation factor 11(GDF11)and ferredoxin 1(FDX1)levels with postoperative major adverse cardiovascular events(MACE)in the patients with coronary heart disease(CHD)undergoing percutaneous coronary intervention(PCI).Methods A total of 153 patients with CHD admitted and treated in this hospital from October 2021 to October 2023 were selected as the research subjects.The patients were followed up for 6 months after PCI.Based on the occurrence of MACE during the follow-up period,the patients were divided in-to the MACE group and non-MACE group.Serum CgA,GDF11 and FDX1 levels were detected by the en-zyme-linked immunosorbent assay(ELISA).The multivariate Logistic regression was used to analyze the in-fluencing factors of MACE occurrence after PCI in CHD patients.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficiency of serum CgA,GDF11 and FDX1 alone and 3-item combi-nation for the MACE occurrence after PCI in CHD patients.Results Compared with the non-MACE group,the proportion of New York Heart Association(NYHA)function class Ⅱ-Ⅲ,proportion of multivessel dis-ease and serum CgA level in the MACE group were higher,while the serum GDF11 and FDX1 levels were lower,and the differences were statistically significant(P<0.05).The multivariate Logistic regression analy-sis showed that increased serum CgA level,NYHA function class Ⅱ-Ⅲ,and multivessel disease were all risk factors for MACE after PCI in CHD patients(P<0.05);increased serum GDF11 and FDX1 levels were both protective factors for MACE after PCI in CHD patients(P<0.05).The areas under the curves(AUCs)of se-rum CgA,GDF11 and FDX1 alone and 3-item combination for predicting the MACE occurrence after PCI in CHD patients were 0.863,0.872,0.757 and 0.962,respectively.The AUC of the 3-item combination was greater than that of serum CgA(Z=3.619,P<0.001),GDF11(Z=3.209,P=0.001),and FDX1(Z=4.978,P<0.001)alone.Conclusion The serum CgA level before PCI is increased in CHD patients with post-operative MACE occurrence,while the serum GDF11 and FDX1 levels are decreased.The combined detection of the serum CgA,GDF11 and FDX1 has a higher predictive value for MACE after PCI,which could provide a reference for the early screening of high-risk populations in clinic.
严昕;郑宏超;缪培智
上海市徐汇区中心医院:心内科,上海 200237上海市徐汇区中心医院:心内科,上海 200237上海市徐汇区中心医院:心血管内科,上海 200237
医药卫生
冠心病嗜铬粒蛋白A生长分化因子11铁氧还蛋白1主要不良心血管事件经皮冠状动脉介入治疗
coronary heart diseasechromogranin Agrowth differentiation factor 11ferredoxin-1major adverse cardiovascular eventspercutaneous coronary intervention
《检验医学与临床》 2026 (10)
1313-1319,7
上海市徐汇区卫生健康委员会项目(SHXHZDXK202305).
评论