Wnt-1和DKK-1在早发急性冠脉综合征中的变化及意义

目的探讨血清Wnt-1和Dickkopf-1（DKK-1）与早发急性冠脉综合征的关系。方法根据病情严重程度将年龄〈40岁的急性冠脉综合征患者分为不稳定型心绞痛组（UAP组，77例）、非ST段抬高型心肌梗死组（NSTEMI组，67例）和ST段抬高型心肌梗死组（STEMI组，46例）；选年龄相匹配的冠状动脉造影正常者作为对照组（40例）。ELISA法测定血清Wnt-1和DKK-1水平，比较各组间的差异，并与病情严重程度作相关性分析。结果UAP组、NSTEMI组和STEMI组血清Wnt-1水平分别为63．9-471.3（平均153．8）、46．9-392．4（平均118．2）和31．2～311．8（平均90．7）ng／ml，明显低于对照组的84．9-302．6（平均203．1）ng／ml（P〈0．05）。血清DKK-1水平各组间差异无统计学意义。相关性分析显示，血清Wnt-1水平与冠心病严重程度呈明显负相关（r=-0．266，P〈0．01）。结论血清Wnt-1水平与早发急性冠脉综合征有相关性，可以反映冠心病的严重程度。

Significance and change of Wnt-1 and DKK-1 in the patients with premature acute coronary syndrome

Objective To investigate whether premature acute coronary syndrome （ACS） is associated with serum Wnt-1 and its antagonist DKK-1 levels. Methods All patients with premature ACS （≤40 years of age） were classified into unstable angina pectoris （UAP） group, non-ST elevated myocardial infarction （NSTEMI） group and ST elevated myocardial infarction （STEMI） group respectively. Sex and age matched people without coronary heart disease was regarded as control group. Serum Wnt-1 and DKK-1 levels were measured by enzyme-linked immunosorbent assay （ELISA） methods. Serum Writ-1 and DKK-1 levels were compared among different group. The correlation was calculated by spearman method. Results The levels of serum Writ-1 were significant lower in patients with UAP group 63.9-471.3 （ 153.8 ）ng/ml ], NSTEMI group 46.9-392.4 （ 118.2 ）ng/ml] and STEMI group 31.2-311.8 （90.7）ng/ml] than the control 84.9-302.6 （ 203.1 ）ng/ml] （P〈0.05）. However, there were no marked changes with serum DKK-1 levels among all groups. The negative correlation was found between serum Wnt-1 levels and the severity of ACS. Conclusion This study establishes an association between low Wnt-1 levels and premature ACS. And serum Wnt-1 levels may predict the severity of ACS.