血浆颗粒蛋白前体与急性冠状动脉综合征的相关性研究

王家杰; 王永祥; 彭瑜; 徐金; 张钲

doi:10.13201/j.issn.1001-1439.2021.12.005

血浆颗粒蛋白前体与急性冠状动脉综合征的相关性研究

- 1. 兰州大学第一临床医学院(兰州, 730000);
- 2. 甘肃省心血管疾病重点实验室;
- 3. 兰州大学第一医院心脏中心
基金项目:
科技部国家重点研发计划项目(No:2018YFC1311505)

甘肃省心血管疾病重点实验室建设项目(No:1206RTSA025)

2020兰州大学中央高校基本科研专项资金(No:lzujbky-2020-kb18)

甘肃省心血管病临床医学研究中心(No:甘科技[2018]20号)

重大疑难病中西医临床协作试点项目(No:国中医药办政发[2018]3号)

甘肃省卫生行业科研计划项目(No:GSWSKY-2019-15)

详细信息

通讯作者: 张钲,E-mail:zhangccu@163.com

中图分类号: R541.4

收稿日期: 2021-06-24

修回日期: 2021-08-26

Correlation between plasma granule protein precursors and acute coronary syndrome

- 1. First Clinical College, Lanzhou University, Lanzhou, 730000, China;
- 2. Key Laboratory of Cardiovascular Diseases;
- 3. Heart Center of the First Hospital of Lanzhou University

More Information

Corresponding author: ZHANG Zheng, E-mail: zhangccu@163.com

Received Date: 24 June 2021

Revised Date: 26 August 2021

摘要

摘要: 目的:探讨血浆颗粒蛋白前体(PGRN)水平与急性冠状动脉综合征(ACS)的相关性,评价其对ACS各亚型[不稳定型心绞痛(UA)、非ST段抬高型心肌梗死(NSTEMI)、ST段抬高型心肌梗死(STEMI)]的诊断能力。方法:收集ACS患者150例(包括UA患者52例,NSTEMI患者51例,STEMI患者47例)。另选取冠状动脉造影阴性对照组41例。收集临床基线资料,分析ACS危险因素水平。通过酶联免疫吸附试验(ELISA)测定血浆PGRN水平,评价其与ACS各亚型的相关性。通过受试者工作特征曲线(ROC)评价PGRN对ACS亚型的诊断效能。结果:随着ACS病理程度(对照-UA-NSTEMI-STEMI)进展,PGRN水平逐渐下降[12.06(8.41,23.79)、7.91(5.86,13.46)、7.01(4.82,9.30)、3.45(2.26,5.71)ng/mL,P<0.001]。ROC曲线分析表明,PGRN水平鉴别诊断对照和STEMI的曲线下面积(AUC)为0.885(95%CI:0.815~0.954,P<0.001),灵敏度和特异度分别为0.88和0.81;PGRN鉴别UA和STEMI的AUC为0.823(95%CI:0.736~0.911,P<0.001),灵敏度和特异度为0.92和0.70。多元Logistic回归分析提示,PGRN水平是影响ACS发生的独立保护因素。结论:血浆PGRN水平与ACS发生相关,且有望作为诊断STEMI的新型标志物。
- 急性冠状动脉综合征 /
- 颗粒蛋白前体 /
- 肌钙蛋白
Abstract: Objective: To investigate the correlation between plasma granule protein precursor(PGRN) level and acute coronary syndrome(ACS), and evaluate its diagnostic ability for subtypes of ACS[unstable angina pectoris(UA), non-ST segment elevation myocardial infarction(NSTEMI), ST segment elevation myocardial infarction(STEMI) ].Methods: A total of 150 ACS patients(including 52 UA patients, 51 NSTEMI patients, and 47 STEMI patients) and 41 controls(coronary angiography verified) were enrolled in this study. Clinical baseline data were collected, and ACS risk factor were analyzed. Plasma PGRN level was assessed by enzyme-linked immunosorbent assay(ELISA), and its correlation with ACS subtypes was evaluated. The diagnostic efficacy of PGRN for the ACS subgroup was evaluated by receiver operating characteristic curve(ROC).Results: The level of PGRN gradually declined as the degree of ACS pathology(control-UA-NSTEMI-STEMI) progressed[12.06(8.41, 23.79), 7.91(5.86, 13.46), 7.01(4.82, 9.30), 3.45(2.26, 5.71), P<0.001]. ROC curve analysis showed that the area under the curve(AUC) of PGRN level differential diagnosing controls and STEMI was 0.885(95%CI: 0.815-0.954, P<0.001), and the sensitivity and specificity were 0.88 and 0.81, respectively; The AUC of PGRN level differential diagnosing UA and STEMI was 0.823(95%CI: 0.736-0.911, P<0.001), and the sensitivity and specificity were 0.92 and 0.70, respectively. Multivariate linear regression analysis suggested that PGRN level was an independent protective factor for ACS occurrence.Conclusion: Plasma PGRN level is associated with ACS occurrence and is expected to be a new marker for diagnosing STEMI.
- acute coronary syndrome /
- granule protein precursor /
- troponin

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参考文献(23)

[1]	Crea F,Libby P.Acute coronary syndromes:the way forward from mechanisms to precision treatment[J].Circulation,2017,136(12):1155-1166.
[2]	Anderson JL,Morrow DA.Acute myocardial infarction[J].New Engl J Med,2017,376(21):2053-2064.
[3]	Dong CH,Wang ZM,Chen SY.Neutrophil to lymphocyte ratio predict mortality and major adverse cardiac events in acute coronary syndrome:A systematic review and meta-analysis[J].Clin Biochem,2018,52:131-136.
[4]	Kanazawa M,Kawamura K,Takahashi T,et al.Multiple therapeutic effects of progranulin on experimental acute ischaemic stroke[J].Brain,2015,138(Pt 7):1932-1948.
[5]	Tang W,Lu Y,Tian QY,et al.The growth factor progranulin binds to TNF receptors and is therapeutic against inflammatory arthritis in mice[J].Science,2011,332(6028):478-484.
[6]	Tian R,Li Y,Yao X.PGRN Suppresses inflammation and promotes autophagy in keratinocytes through the Wnt/β-catenin signaling pathway[J].Inflammation,2016,39(4):1387-1394.
[7]	Wei F,Zhang Y,Jian J,et al.PGRN protects against colitis progression in mice in an IL-10 and TNFR2 dependent manner[J].Sci Rep,2014,4:7023.
[8]	Xu X,Gou L,Zhou M,et al.Progranulin protects against endotoxin-induced acute kidney injury by downregulating renal cell death and inflammatory responses in mice[J].Int Immunopharmacol,2016,38:409-419.
[9]	Mourouzis K,Oikonomou E,Siasos G,et al.Pro-inflammatory cytokines in acute coronary syndromes[J].Curr Pharm Des,2020,26(36):4624-4647.
[10]	张新超,于学忠,陈凤英,等.急性冠脉综合征急诊快速诊治指南[J].临床急诊杂志,2019,20(4):253-262.
[11]	Canadian Cardiovascular Society,American Academy of Family Physicians,American College of Cardiology,et al.2007 focused update of the ACC/AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2008,51(2):210-47.
[12]	Anderson JL,Adams CD,Antman EM,et al.ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2007,50(7):1-157.
[13]	Fraker TD Jr,Fihn SD,2002 Chronic Stable Angina Writing Committee,et al.2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina[J].J Am Coll Cardiol,2007,50(23):2264-2274.
[14]	郑淑苹,罗超迪,王萍,等.ACS患者血浆纤维蛋白原与冠状动脉病变严重程度的关系[J].临床心血管病杂志,2021,37(7):625-631.
[15]	Ross R.Atherosclerosis is an inflammatory disease[J].Am Heart J,1999,138(5 Pt 2):S419-420.
[16]	Ridker PM,MacFadyen JG,Everett BM,et al.Relationship of C-reactive protein reduction to cardiovascular event reduction following treatment with canakinumab:a secondary analysis from the CANTOS randomised controlled trial[J].Lancet,2018,391(10118):319-328.
[17]	包海梅,王蒙琴,韩轩茂,等.急性冠状动脉综合征患者乙酰肝素酶与白细胞的表达水平及其临床意义[J].临床心血管病杂志,2019,35(5):430-432.
[18]	Hrabal R,Chen Z,James S,et al.The hairpin stack fold,a novel protein architecture for a new family of protein growth factors[J].Nat Struct Biol,1996,3(9):747-752.
[19]	Suh HS,Choi N,Tarassishin L,et al.Regulation of progranulin expression in human microglia and proteolysis of progranulin by matrix metalloproteinase-12(MMP-12)[J].PLoS One,2012,7(4):e35115.
[20]	Wang J,Wei G,Hu W,et al.Expression of matrix metalloproteinases-12 in ST-segment elevation myocardial infarction:A case-control study[J].Medicine(Baltimore),2017,96(40):e8035.
[21]	Fu W,Hu W,Shi L,et al.Foxo4-and Stat3-dependent IL-10 production by progranulin in regulatory T cells restrains inflammatory arthritis[J].FASEB J,2017,31(4):1354-1367.
[22]	Libby P,Tabas I,Fredman G,et al.Inflammation and its resolution as determinants of acute coronary syndromes[J].Circ Res,2014,114(12):1867-1879.
[23]	Sharma M,Schlegel MP,Afonso MS,et al.Regulatory T cells license macrophage pro-resolving functions during atherosclerosis regression[J].Circ Res,2020,127(3):335-353.