五聚素3对急性冠脉综合征患者预后的评估价值

目的:通过分别检测急性冠脉综合征(ACS)患者和对照者血浆五聚素3(PTX3)的水平,探讨PTX3在ACS发生发展中的作用及其对ACS患者预后的临床价值。方法:连续入选ACS患者80例,其中ST段抬高心肌梗死组(STEMI)组32例、非ST段抬高心肌梗死组(NSTEMI)组23例、不稳定性心绞痛组(UAP)组25例,同期选取经冠脉造影排除冠心病的20例患者作为对照组,取所有入院患者的静脉血用ELISA法测定PTX3水平,随访ACS患者出院后3个月不良心血管事件的发生情况。结果:ACS患者血浆PTX3水平显著高于对照组(P<0.001),ACS患者血浆PTX3水平与WBC(r=0.359,P=0.001)、hs-CRP(r=0.405,P<0.000 1)以及NT-ProB-NP(r=0.883,P<0.0001)有显著相关性。PTX3≥5.51μg/L组3个月联合心血管事件发生率高于PTX3<5.51μg/L组(39.5%比17.5%,P<0.05)。多元Logistic回归分析结果显示,只有PTX3(OR=4.11,95%CI:1.37-12.38,P=0.012)和NT-ProBNP(OR=2.56,95%CI:1.12-4.53,P=0.021),而非hs-CRP,是ACS患者3个月不良心血管事件的独立预测因子。结论:PTX3可能促成了动脉粥样硬化的发病机制,PTX3和NT-proBNP是ACS患者3个月主要不良心血管事件强力且独立的预后指标。联合检测PTX3和NT-proBNP可能有助于ACS患者早期危险分层。

Prognostic Value of Pentraxin 3 in Patients with Acute Coronary Syndrome

Objective:To explore the role of plasma Pentraxin 3(PTX3) in the development of acute coronary syndrome(ACS),and to assess the prognostic value of PTX3 in patients with ACS, through detecting the plasma levels of PTX3 in ACS patients and normal controls.Methods; Eighty consecutive patients with ACS,including 32 cases of ST-segment elevation myocardial infarction (STEMI) patients,23 cases of non-ST-segment elevation myocardial infarction(NSTEMI) patients,and 25 cases of unstable angina pectoris(UAP) patients,were included in this study.Another 20 patients who were excluded coronary artery disease by coronary angiography were set as the control group on the corresponding period.All hospitalized patients were detected plasma PTX3 by ELISA,and followed up for 3 months after discharge to observe the situation about adverse cardiovascular events.Results:Plasma PTX3 levels in ACS group were significant- ly higher than in control group(P<0.001).In patients with ACS,plasma PTX3 levels significant correlated with white blood cell count(WBC) 0=0.359,P = 0.001),hs-CRP(r=0.405, P<0.000 1) and NT-ProBNP 0=0.883,P<0.000 1).Compared with patients with PTX3<5. 51μg/L,patients with higher plasma PTX3 concentration had a higher 3-month combined cardiovascular event rate(39.5%vs 17.5%,P<0.05).Multiple logistic regression analysis showed that only PTX3(Or=4.11,95%CI:1.37-12.38,P = 0.012) and NT-ProBNP(0=2.56,95% CI:1.12-4.53,P = 0.021),but not hs-CRP,were independent predictors for the 3-month cardiovascular end point events in patients with ACS.Conclusion:PTX3 may contribute to the pathogenesis of atherosclerosis.PTX3 and NT-proBNP,but not hs-CRP,were powerful independent prognostic indicators for the 3-month cardiovascular end point events in patients with ACS.Combined detection of PTX3 and NT-proBNP may substantially contribute to the early risk stratification in patients with ACS.