血清基质细胞衍生因子-1、趋化因子CCL21与老年急性冠脉综合征病人临床预后的关系

doi:10.3969/j.issn.1003-9198.2022.06.011

摘要/Abstract

摘要： 目的探讨血清基质细胞衍生因子-1(SDF-1)、趋化因子CCL21对行经皮冠状动脉介入治疗(PCI)的老年急性冠脉综合征(ACS)病人临床预后的预测价值。方法回顾性分析2016~2018年在我院接受PCI治疗的186例老年ACS病人的临床资料,根据病人随访1年期间主要不良心血管事件(MACE)发生情况,分为预后不良组86例(有MACE)和预后良好组100例(无MACE)。采用ELISA法检测病人的血清SDF-1、CCL21水平。采用多因素Logistic回归分析老年ACS病人PCI术后短期不良预后的危险因素;绘制ROC曲线,评估血清SDF-1、CCL21对老年ACS病人PCI术后短期预后不良的诊断效能。结果 2组心率、高血压病史、LVEF、SDF-1、CCL21、LDL-C、HDL-C、肌钙蛋白、N末端脑钠肽前体(NT-proBNP)水平和GRACE评分差异均有统计学意义(P<0.05或0.01)。多因素Logistic回归分析示:LVEF、GRACE评分、SDF-1和CCL21是老年ACS病人PCI术后短期预后不良的独立影响因素。血清SDF-1、CCL21联合检测预测老年ACS病人PCI术后短期预后不良的AUC为0.930,灵敏度为0.841,特异度为0.857,均高于单一指标检测。结论血清SDF-1、CCL21是老年ACS病人PCI术后短期预后不良的独立影响因素,两指标联合检测对老年ACS病人临床预后有较高的预测价值。

关键词: 基质细胞衍生因子-1, 趋化因子CCL21, 急性冠脉综合征, 预后, 老年人

Abstract: Objective To investigate the predictive value of serum stromal cell-derived factor-1 (SDF-1) and chemokine CCL21 for the clinical prognosis of the elderly patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods The clinical data of 186 elderly patients with ACS who received PCI in our hospital from 2016 to 2018 were retrospectively analyzed. According to the occurrence of major adverse cardiovascular events (MACE) during 1-year follow-up, the patients were divided into poor prognosis group (86 patients with MACE) and good prognosis group (100 patients without MACE). The serum levels of SDF-1 and CCL21 were measured by enzyme-linked immunosorbent assay (ELISA). The risk factors for poor prognosis of the elderly patients were analyzed by multivariate Logistic regression. Receiver operating characteristic(ROC) curve was drawn to evaluate the diagnostic value of serum SDF-1 and CCL21 for the short-term poor prognosis of the elderly ACS patients after PCI. Results There were significant differences in the levels of heart rate, left ventricular ejection fraction (LVEF), SDF-1, CCL21, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), troponin and N-terminal pro-B type natriuretic peptide (NT-proBNP), the prevalence of hypertension and the score of GRACE scale between the two groups (P<0.05 or 0.01). Multivariate Logistic regression analysis showed that LVEF, GRACE score, SDF-1 and CCL21 were the independent influencing factors for poor prognosis in the elderly patients. The area under the ROC curve of serum SDF-1 combined with CCL21 in predicting short-term poor prognosis of the elderly patients was 0.930, with a sensitivity and a specificity of 0.841 and 0.857, respectively. Conclusions Serum SDF-1 and CCL21 are the independent influencing factors for short-term poor prognosis of the elderly ACS patients after PCI. The combination of the two indicators has a high predictive value for clinical prognosis in the elderly patients with ACS.

Key words: stromal cell-derived factor-1, chemokine CCL21, acute coronary syndrome, prognosis, aged

中图分类号:

R 543.3

李亚云. 血清基质细胞衍生因子-1、趋化因子CCL21与老年急性冠脉综合征病人临床预后的关系[J]. 实用老年医学, 2022, 36(6): 592-595.

LI Ya-yun. Relationship between serum stromal cell-derived factor-1, chemokine CCL21 and clinical prognosis in elderly patients with acute coronary syndrome[J]. Practical Geriatrics, 2022, 36(6): 592-595.

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