血清Furin、Nesfatin-1水平与急性ST段抬高型心肌梗死预后的关系-东南大学学报医学版

血清Furin、Nesfatin-1水平与急性ST段抬高型心肌梗死预后的关系

单位：大连大学附属中山医院老年病科, 辽宁大连 116001

分类号：R541.4

出版年·卷·期（页码）：2022·41·第二期（260-265）

摘要：

目的:探讨血清弗林蛋白酶(Furin)、摄食抑制因子-1(Nesfatin-1)与急性ST段抬高型心肌梗死(STEMI)预后的关系。方法:选取2018年1月至2020年1月在我院行急诊经皮冠状动脉介入治疗(PCI)的急性STEMI患者132例(设为心肌梗死组),术后随访6个月,根据患者是否发生主要心血管不良事件(MACE),分为MACE组(95例)和无MACE组(37例);另选取我院体检健康志愿者100例作为对照组。采用酶联免疫吸附法检测血清Furin、Nesfatin-1水平。采用多因素Logistic回归分析影响急性STEMI患者MACE发生的危险因素。结果:心肌梗死组血清Furin、Nesfatin-1水平与对照组比较差异有统计学意义(P＜0.05)。MACE组血清Furin水平高于无MACE组,Nesfatin-1水平低于无MACE组,差异均有统计学意义(均P＜0.05)。多因素Logistic回归分析显示,血清Furin水平升高、Nesfatin-1水平降低是急性STEMI患者MACE发生的独立危险因素(P＜0.05)。受试者工作特征(ROC)曲线分析显示,血清Furin、Nesfatin-1及二者联合检测预测急性STEMI患者MACE发生的曲线下面积(AUC)分别为0.795、0.819及0.897。结论:急性STEMI患者血清Furin水平升高、Nesfatin-1水平降低,其是患者MACE发生的重要危险因素,可作为判断患者预后状态的辅助参考指标。

Objective: To investigate the relationship between serum furin(Furin), feeding inhibitor-1(Nesfatin-1) and the prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods: A total of 132 patients with acute STEMI who underwent emergency PCI treatment in our hospital from January 2018 to January 2020(myocardial infarction group) were selected. The patients were followed up for 6 months after operation. According to whether the patients had major adverse cardiovascular events(MACE), they were divided into MACE group(n＝95) and MACE-free group(n＝37). In addition, 100 healthy volunteers undergoing physical examination in our hospital were selected as control group. Enzyme-linked immunosorbent assay was used to detect serum Furin and Nesfatin-1 levels. Multivariate logistic regression analysis was used to analyze the risk factors affecting the occurrence of MACE in patients with acute STEMI. Results: Compared with the control group, the serum Furin and Nesfatin-1 levels in the myocardial infarction group were significantly different(P＜0.05). Serum Furin level in MACE group was higher than that in MACE-free group, and serum Nesfatin-1 level in MACE group was lower than that in MACE-free group, the difference being statistically significant(P＜0.05). Multivariate logistic regression analysis showed that increased serum Furin levels and decreased Nesfatin-1 levels were independent risk factors for MACE in patients with acute STEMI(P＜0.05). ROC curve results showed that serum Furin, Nesfatin-1 and the combined detection of the two in predicting the AUC of MACE in patients with acute STEMI were 0.795, 0.819 and 0.897 respectively. Conclusion: Serum Furin levels increase and Nesfatin-1 levels decrease in patients with acute STEMI, which are important risk factors for MACE. It can be used as an auxiliary reference index in judging the prognosis of patients.

参考文献：

[1] 郝增光,杨晓红,韩兆帅,等.急性心肌梗死患者血清超敏C反应蛋白、组织蛋白酶S、可溶性细胞表面分化抗原40配体水平与病情程度及预后的相关性[J].临床内科杂志,2021,38(4):250-253.
[2] HUDSON M.In suspected AMI,an extended algorithm increased sensitivity and decreased specificity for predicting 30 day MACE[J].Ann Intern Med,2020,172(2):JC11.
[3] YAKALA G K,CABRERA-FUENTES H A,CRESPO-AVILAN G E,et al.FURIN inhibition reduces vascular remodeling and atherosclerotic lesion progression in mice[J].Arterioscler Thromb Vasc Biol,2019,39(3):387-401.
[4] 王璐媛,刘莉萍,李遇梅,等.Nesfatin-1及其与皮肤疾病[J].中国皮肤性病学杂志,2018,32(6):697-701.
[5] 卢青虎,刘世刚,张红岩.稳定型冠心病合并肥胖患者血清Ghrelin nesfatin-1 Obestatin的临床意义[J].河北医学,2021,27(4):639-644.
[6] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2015,43(5):380-393.
[7] 周瑜,王勉.瑞舒伐他汀对急性心肌梗死病人心功能及内皮功能的影响[J].中西医结合心脑血管病杂志,2017,15(7):826-830.
[8] 胡海鹰,于亚梅,余云华,等.老年急性心肌梗死患者经皮冠状动脉介入治疗的近远期预后[J].中国老年学杂志,2019,39(9):2049-2052.
[9] YANG X,YANG W,MCVEY D G,et al.FURIN expression in vascular endothelial cells is modulated by a coronary artery disease-associated genetic variant and influences monocyte transendothelial migration[J].J Am Heart Assoc,2020,9(4):e014333.
[10] 李艳,王静,袁琛,等.Furin基因对高血压心肌梗死细胞增殖、迁移以及作用机制的研究[J].临床和实验医学杂志,2018,17(9):913-916.
[11] WANG Y K,TANG J N,HAN L,et al.Elevated furin levels in predicting mortality and cardiovascular events in patients with acute myocardial infarction[J].Metabolism,2020,111:154323.
[12] IBE S,KISHIMOTO Y,NIKI H,et al.Associations between plasma nesfatin-1 levels and the presence and severity of coronary artery disease[J].Heart Vessels,2019,34(6):965-970.
[13] KADOGLOU N P E,KORAKAS E,LAMPROPOULOS S,et al.Plasma nesfatin-1 and DDP-4 levels in patients with coronary artery disease:Kozani study[J].Cardiovasc Diabetol,2021,20(1):166.
[14] SERDAR-KUYUMCU M,KUYUMCU A,YAYLA Ç,et al.The relationship between nesfatin-1 levels and SYNTAX score in patients with non-ST segment elevation myocardial infarction[J].Acta Cardiol Sin,2018,34(5):386-393.
[15] 陈赟赟,卢冬雨.血清肌红蛋白联合SYNTAX-Ⅱ评分对急性心肌梗死PCI术后近期预后的预测分析[J].中国急救医学,2020,40(10):961-965.
[16] 党璋,吴琼,王娟,等.GDF-15、sST2及cTnI在急性心肌梗死患者中的表达及其对预后的预测价值研究[J].临床误诊误治,2021,34(2):49-53.
[17] 李永勤,范艳梅,薛嘉红,等.高敏C反应蛋白联合高敏心肌肌钙蛋白T对急性冠状动脉综合征患者预后的判断价值[J].中国医师进修杂志,2014,37(22):5-9.
[18] SIVRI S,SOKMEN E,ÇELIK M,et al.Nesfatin-1 levels predict angiographic no-reflow in patients with ST-segment elevation myocardial infarction[J].Acta Cardiol Sin,2020,36(4):318-325.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录