南方医科大学学报

南方医科大学学报 ›› 2021, Vol. 41 ›› Issue (5): 710-715.doi: 10.12122/j.issn.1673-4254.2021.05.11

• • 上一篇    下一篇

血清 ADAMTS13、TSP1 与急性冠脉综合征患者心肌损伤和临床预后的相关性

姚卓亚，包炳蔚，钱少环，李 正，路 桥，闵生萍，李妙男，王洪巨   

  • 出版日期:2021-05-20 发布日期:2021-06-11

Correlation of serum ADAMTS13 and TSP1 levels with myocardial injury and prognosis in patients with acute coronary syndrome

  • Online:2021-05-20 Published:2021-06-11

RichHTML

35

PDF

361

摘要： 目的 观察血清血管性血友病因子裂解蛋白酶（ADAMTS13）及凝血酶敏感蛋白1（TSP1）在不同类型急性冠脉综合征（ACS）患者中的水平及与临床预后之间的相关性。方法 入选405例我院行冠状动脉造影患者，根据病史、造影结果和临床生化指标分为：不稳定型心绞痛组（UAP组，n=215）、急性心肌梗死组（AMI组，n=96）和造影正常组（N组，n=94）。检测患者的血清ADAMTS13、TSP1水平；对两组患者进行约15月的随访，评估两组患者远期主要心脏不良事件（MACE）的发生情况。结果AMI组、UAP组患者血清ADAMTS13水平显著低于N组（P<0.001），TSP1水平显著高于N组（P<0.001）；相关性分析显示，ACS患者血清ADAMTS13与TSP1呈显著负相关（R=-0.577，P<0.001）。随访平均15月后发现MACE组患者血清TSP1水平与非MACE组有显著差异（P<0.05）；Cox比例危险回归显示TSP1是影响ACS患者发生MACE的风险因素；K-M生存曲线显示高TSP1组较低TSP1组远期MACE发生率更高。结论 血清ADAMTS13水平的降低、TSP1水平的升高对ACS的诊断具有一定参考价值；TSP1可预测患者发生MACE的风险。

关键词: ADAMTS13；TSP1；急性冠脉综合征；临床预后

Abstract: Objective To investigate serum levels of von Willebrand factor lytic protease (ADAMTS13) and thrombospondin-1 (TSP1) in patients with different types of acute coronary syndrome (ACS) and their correlation with the patients' clinical prognosis. Methods According to their disease history, results of angiography and clinical biochemical tests, a total of 405 patients undergoing coronary angiography, were divided into unstable angina (UAP) group (n=215), acute myocardial infarction (AMI) group (n=96), and angiographically normal group (n=94). Serum ADAMTS13 and TSP1 levels were detected in all the patients, who were followed up for 15 months to evaluate the occurrence of long-term major cardiac adverse events (MACE). Results Serum ADAMTS13 level was significantly lower and TSP1 level was significantly higher in AMI group and UAP group than in the normal group (P<0.001). Serum ADAMTS13 and TSP1 levels were negative correlated in ACS patients (R=-0.577, P<0.001). The patients experiencing MACE had significantly different serum TSP1 level from those without MACE (P<0.05). Cox proportion regression model analysis showed that TSP1 was a risk factor affecting the occurrence of MACE in ACS patients; Kaplan-Meier survival analysis showed that the patients with high levels of TSP1 had a higher incidence of long-term MACE than those with low TSP1 levels. Conclusion A lowered serum ADAMTS13 level and an elevated TSP1 level can support the diagnosis of ACS. An elevated TSP1 level may serve as an indicator for predicting the risk of MACE in patients with ACS.

Key words: ADAMTS13; thrombospondin-1; acute coronary syndrome; clinical prognosis