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Angpt1和Angpt2与hs-cTnT评估心绞痛PCI术后心血管不良事件的价值
邓丽丽,胡容,刘艳,李岩辉,陈天艺
0
(宜宾市第二人民医院检验科;西南医科大学;江安县中医院检验科)
摘要:
【摘要】目的 探讨血管生成素样蛋白1(Angpt1)、血管生成素样蛋白2(Angpt2)及高敏肌钙蛋白T(hscTnT)预测行经皮冠脉介入治疗(PCI)心绞痛患者心血管不良事件(MACE)的价值。方法 收集2015年3月~2018年5月宜宾市第二人民医院收治行PCI治疗的123例心绞痛患者,比较不同分级患者血清Angpt1、Angpt2及hscTnT的差异;按随访1年是否发生MACE分组,筛选心绞痛发生MACE危险因素,分析以上参数对PCI治疗心绞痛发生MACE的预测价值及三者之间相关关系。结果 随心绞痛病情分级的上升,血清Angpt2、hscTnT水平上升,Angpt1降低(P<005);MACE组血清Angpt2、hscTnT水平高于非MACE组,Angpt1水平低于非MACE组(P<0.05);MACE组左室射血分数(LVEF)<50%、氨基末端脑钠肽前体(NTproBNP)≥500 pg/mL、心绞痛分级为Ⅲ级比例高于非MACE组(P<005);Angpt2、hscTnT、LVEF、NTproBNP、心绞痛分级均为PCI术后发生MACE的危险因素(P<005);Angpt2预测PCI术后发生MACE约登指数最大时敏感度、特异性分别为9565%、7900%;hscTnT约登指数最大时敏感度、特异性分别为7391%、8900%;Angpt1约登指数最大时敏感度、特异性分别为6087%、8200%;Angpt2与Angpt1呈负相关(P<005),与hscTnT呈正相关(P<005),Angpt1与hscTnT呈负相关(P<005)。结论 不稳定型心绞痛行PCI术后MACE发生与Angpt1、Angpt2、hscTnT浓度变化有关;Angpt2、hscTnT对不稳定型心绞痛PCI术后MACE发生有较高的预测价值,而Angpt1预测价值有限。
关键词:  心绞痛  经皮冠脉介入治疗  血管生成素样蛋白  高敏肌钙蛋白T  心血管不良事件
DOI:
基金项目:四川省卫计委应用基础研究课题(17PJ567)
Value of angpt1 angpt2and hs-cTnT in evaluating adverse cardiovascular events in angina patients undergoing PCI
DENG Lili,HU Rong,LIU Yan,LI Yanhui,CHEN Tianyi
(Department of Clinical Laboratory, Yibin Second People's Hospital;Southwestern Medical University;Department of Laboratory Medicine, Jiang'an County Traditional Chinese Medicine Hospital)
Abstract:
【Abstract】Objective To explore the value of angiopoietinlike protein 2 (Angpt2), angiopoietinlike protein 1 (Angpt1) and highsensitivity troponin T (hscTnT) in predicting major adverse cardiovascular events (MACE) in angina patients undergoing percutaneous coronary intervention (PCI). Methods A total of 123 angina patients underwent PCI in Yibin Second People's Hospital from March 2015 to May 2018 were enrolled. Serum Angpt2, Angpt1 and hscTnT were compared among patients with different grades of angina. They were grouped according to the occurrence of MACE during the 1year followup. Risk factors for MACE were screened. The predictive value of above parameters for MACE in angina patients undergoing PCI, and the correlation among the three indicators were analyzed. 〖WTHZ〗ResultsWith the increase of the grade of angina, levels of serum Angpt2 and hscTnT increased, while the Angpt1 level decreased (P<005). The levels of serum Angpt2 and hscTnT in MACE group were higher than those in nonMACE group, while the Angpt1 level was lower than nonMACE group (P<005). The proportions of left ventricular ejection fraction (LVEF) lower than 50%, N terminal pro B type natriuretic peptide (NTproBNP) not higher than 500 pg/mL and grade III angina in MACE group were higher than those in nonMACE group (P<005). Angpt2, hscTnT, LVEF, NTproBNP and angina grading were all risk factors for MACE after PCI (P<005). When the Youden index of Angpt2 for predicting MACE after PCI was the largest, the sensitivity and specificity were 9565% and 7900%. When the Youden index of hscTnT was the largest, the sensitivity and specificity were 7391% and 8900%. When the Youden index of Angpt1 was the largest, the sensitivity and specificity were 6087% and 8200%. Angpt2 was negatively correlated with Angpt1 (P<005), but positively correlated with hscTnT (P<005). Angpt1 was negatively correlated with hscTnT (P<005). Conclusion The occurrence of MACE in patients with unstable angina after PCI is related to changes in levels of Angpt2, Angpt1 and hscTnT. Angpt2 and hscTnT are of great value for predicting MACE after PCI while the predictive value of Angpt1 is limited. There is a correlation among the expression of the three indicators.
Key words:  Angina  PCI  Angiopoietin  High sensitivity troponin T  Adverse event

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