急性冠脉综合征患者HIGD-1A及HIGD-1B蛋白水平及意义

  目的  通过检测急性冠脉综合征(ACS)患者血清缺氧诱导基因结构域蛋白-1A(HIGD-1A)、缺氧诱导基因结构域蛋白-1B(HIGD-1B)蛋白水平，分析其与急性冠脉综合征发生发展的关系。  方法  选择2019年9月—2021年9月就诊于蚌埠医学院第一附属医院心血管内科经冠状动脉造影确诊为ACS的患者106例，包括急性心肌梗死(AMI)患者50例、不稳定型心绞痛(UAP)患者56例，稳定型心绞痛(SAP)患者20例，选取同时期冠脉造影未见异常的患者34例作为正常组，采用ELISA法检测HIGD-1A、HIGD-1B蛋白，评估各组间差异。  结果  ACS组血清HIGD-1B蛋白与正常组比较差异有统计学意义(P＜0.001)。ACS组、SAP组、正常组血清HIGD-1A蛋白差异无统计学意义(P=0.123)。根据Gensini积分，将冠脉病变程度分为轻度病变组29例，中度病变组40例，重度病变组37例，不同病变程度ACS患者HIGD-1B水平差异有统计学意义(P＜0.001)。经Pearson相关性分析，ACS患者HIGD-1B水平与Gensini积分成正相关关系(r=0.685，P＜0.001)。绘制ROC曲线，血清HIGD-1B水平预测急性冠脉综合征的AUC为0.940，灵敏度为84.0%，特异度为94.1%，约登指数为0.781，具有一定的诊断参考价值。  结论  急性冠脉综合征患者血清HIGD-1B蛋白显著升高，且与冠脉严重程度成正相关关系，这对于ACS的诊断具有重要意义。 

The level and significance of HIGD-1A and HIGD-1B protein in patients with acute coronary syndrome

  Objective  To detect serum hypoxia induced genetic structure domain protein-1A (HIGD-1A) and hypoxia induced genetic structure domain protein-1B (HIGD-1B) protein levels in patients with acute coronary syndrome (ACS) and analyze their relationship with the development of ACS.  Methods  A total of 106 patients with acute coronary syndrome (ACS) diagnosed by coronary angiography in the Department of Cardiovascular Medicine, the First Affiliated Hospital of Bengbu Medical College from September 2019 to September 2021 were selected, including 50 patients with acute myocardial infarction (AMI), 56 patients with unstable angina pectoris (UAP), and 20 patients with stable angina pectoris (SAP). Thirty-four patients with normal coronary angiography during the same period were selected as the normal group. The protein levels of HIGD-1A and HIGD-1B were detected by ELISA to evaluate the differences between the groups.  Results  Serum HIGD-1B protein was statistically significant between the ACS and control group (P < 0.001). There was no significant difference in HIGD-1A protein among ACS group, SAP group and normal group (P=0.123). According to Gensini score, the degree of coronary artery disease was divided into mild group (n=29), moderate group (n=40) and severe group (n=37). There was a significant difference in HIGD-1B level among patients with different degrees of coronary artery disease in ACS group (P < 0.001). Pearson correlation analysis showed that HIGD-1B level was positively correlated with Gensini score in ACS group (r=0.685, P < 0.001). When drawing ROC curve, the AUC of serum HIGD-1B level in predicting acute coronary syndrome was 0.940, the sensitivity was 84.0%, the specificity was 94.1%, and the Youden index was 0.781, which had certain diagnostic reference value.  Conclusion  The serum HIGD-1B protein is significantly elevated in patients with acute coronary syndromes and positively correlated with coronary severity, which is of great significance for the diagnosis of ACS.