2022 年第 3 期 第 17 卷

冠心病患者血清心肌营养素1和心型脂肪酸结合蛋白表达与血小板活化状态及预后的相关性研究

Correlation between serum cardiotrophin-1, heart type fatty acid binding protein expressions and platelet activation, prognosis in patients with coronary atherosclerotic heart disease

作者：陈娟邓勇

英文作者：Chen Juan Deng Yong

单位：青海省心脑血管病专科医院干部保健科，西宁810000

英文单位：Department of Health Care for Cadres Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital Xining 810000 China

关键词：冠心病（冠状动脉粥样硬化性心脏病）；心肌营养素1；心型脂肪酸结合蛋白；血小板活化状态

英文关键词：Coronaryatheroscleroticheartdisease;Cardiotrophin-1;Hearttypefattyacidbindingprotein;Plateletactivation

• 摘要：

• 目的 探讨冠心病（冠状动脉粥样硬化性心脏病）患者血清心肌营养素1（CT-1）、心型脂肪酸结合蛋白（H-FABP）表达与血小板活化状态及预后的相关性。方法  选取2017年1月至2019年4月青海省心脑血管病专科医院收治的150例冠心病患者作为观察组，另外选取同期在本院体检者150例作为对照组。比较2组血小板表面α-颗粒膜糖蛋白（CD62p）、溶酶体膜糖蛋白（CD63）、血清CT-1、H-FABP表达水平。分析观察组血清CT-1、H-FABP表达水平与CD62p、CD63水平相关性。绘制受试者工作特征（ROC）曲线评估血清CT-1、H-FABP对冠心病患者发生主要不良心血管事件（MACE）的预测价值。采用Logistic回归模型分析冠心病患者发生MACE的影响因素。结果 观察组高血压史、糖尿病史、高血脂史比例及CD62p、CD63、CT-1、H-FABP水平均高于对照组（均P＜0.05）。观察组血清CT-1、H-FABP表达水平与CD62p、CD63水平均呈正相关（均P＜0.001）。血清CT-1、H-FABP联合预测冠心病患者发生MACE的曲线下面积为0.913，敏感度为78.60%，特异度为91.70%。高血压史、糖尿病史、CD62p＞7.2%、CD63＞7.5%、CT-1＞139.8 ng/L、H-FABP＞9.6 μg/L均为冠心病患者发生MACE的独立危险因素（均P＜0.05）。结论  冠心病患者血清CT-1、H-FABP高表达，其水平与CD62p、CD63水平呈正相关，且对冠心病患者发生MACE有一定预测价值，可用于评估冠心病患者病情进展及预后。

• Objective   To investigate the correlation between serum cardiotrophin-1 (CT-1), heart type fatty acid binding protein (H-FABP) expressions and platelet activation, prognosis in patients with coronary atherosclerotic heart disease (CHD). Methods   From January 2017 to April 2019, 150 patients with CHD admitted to Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital were selected as the observation group, and another 150 healthy people who underwent physical examination in the hospital during the same period were selected as the control group. Platelet surface α-granular membrane protein (CD62p), lysosomal membrane glycoprotein (CD63), serum CT-1 and H-FABP expression levels were compared between the two groups. The correlation between serum CT-1, H-FABP expression levels and CD62p, CD63 levels in the observation group was analyzed. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of serum CT-1 and H-FABP for major adverse cardiovascular events (MACE) in patients with CHD. Logistic regression model was used to analyze the influencing factors of MACE in patients with CHD. Results  The proportions of hypertension history, diabetes mellitus history, hyperlipidemia history and the levels of CD62p, CD63, CT-1 and H-FABP in observation group were higher than those in control group (all P＜0.05). The serum CT-1 and H-FABP expression levels in observation group were positively correlated with CD62p and CD63 levels (all P＜0.001). The area under the curve of serum CT-1 and H-FABP for predicting MACE in patients with CHD was 0.913, the sensitivity was 78.60% and the specificity was 91.70%. Hypertension history, diabetes mellitus history, CD62p＞7.2%, CD63＞7.5%, CT-1＞139.8 ng/L and H-FABP＞9.6 μg/L were independent risk factors of MACE in patients with CHD (all P＜0.05). Conclusions Serum CT-1 and H-FABP are highly expressed in patients with CHD and the levels are positively correlated with CD62p and CD63 levels, with certain predictive value for MACE in patients with CHD, which may be used to evaluate the progress and prognosis of patients with CHD.