骨桥蛋白对稳定型心绞痛患者危险分层的判断价值

目的探讨骨桥蛋白(OPN)对稳定型心绞痛患者危险分层的界值点及其意义。方法采用病例-病例研究,39例稳定型心绞痛患者入院时测定血浆OPN水平,观察6个月时发生不良心血管事件(心原性死亡、非致死性心肌梗死)的情况。应用受试者工作特征曲线(ROC曲线)确定OPN水平界值,根据该值将患者危险分层,分为高危组和低危组。结果血浆OPN水平危险分层的最佳界值取403ng/ml,其敏感性78.6%,特异性90.9%。高危组中发生不良心血管事件13例(76.5%),而无事件者为4例(23.5%);低危组中依次分别为5例(22.7%)和17例(77.3%)。高危组预后情况较低危组更差(76.5%和22.7%,P=0.001;RR3.365,95%CI1.490～7.597)。结论根据血浆OPN水平对稳定型心绞痛患者危险分层的最佳界值为403ng/ml,是较可靠的生化指标。

The value of the osteopontin for risk stratification in the stable angina pectoris patients

s Objective To explore the value of the cutoff point of the osteopontin for risk stratification in stable angina pectoris patients. Methods Plasma OPN levels in baseline were measured in 39 stable angina pectoris patients and angiographically documented CAD. To observe the primary adverse outcome including non-fatal myocardial infarction and death from cardiovascular causes in follow-up for 6 months. The cutoff point of the OPN level was determined by receiver operator characteristic curve(ROC). 39 patients were divided into two groups, high risk and low risk group, according to the cutoff point. Results The best cutoff point of plasma OPN level was 403 ng/ml and its sensitivity and specificity was 78.6% and 90.9%, respectively. The adverse outcome patients accounted for 76.5%,whereas the no adverse outcome ones 23.5% in the high risk group. In contrast, 22.7%and 77.3% in the low risk group, respectively,adverse outcome emerge of the high risk group was more frequent than that of the low risk group(76.5% vs 22.7%,P=0.001,RR 3.365,95% CI 1.490-7.597). Conclusion The best cutoff point of plasma OPN level for risk stratification in stable angina pectoris patients is 403 ng/ml, which is reliable biochemistry marker.