Galectin-3在评估冠状动脉疾病后心肌梗死发生和预后中的价值
2020-06-08罗润发
罗润发
【摘要】 目的:探讨Galectin-3在評估冠状动脉疾病后心肌梗死发生和患者预后的中的价值。方法:收集2016年1月-2017年4月收治的不稳定型心绞痛患者50例(观察组)及稳定型CAD患者50例(对照组),观察两组体内Galectin-3的表达水平;再将观察组依据Galectin-3水平分为三组,分析Galectin-3与病变血管支数的相关性,随访观察各组心肌梗死发生率及预后情况。结果:观察组吸烟患者占比、糖尿病患者占比、高密度脂蛋白、低密度脂蛋白及Galectin-3等指标均高于对照组,差异均有统计学意义(P<0.05)。随着冠状动脉病变支数的增多,Galectin-3水平越高。≥3支血管病变患者Galectin-3水平均高于2支血管病变患者、1支血管病变患者,差异均有统计学意义(t=7.32、11.53,P<0.001);2支血管血管病变患者Galectin-3水平高于1支血管病变患者,差异有统计学意义(t=8.03,P<0.001)。>8.6 ng/ml组心肌梗死发生率均高于<6.6 ng/ml组、6.6~8.6 ng/ml组,差异均有统计学意义(P<0.05)。>8.6 ng/ml组死亡率均高于<6.6 ng/ml组、6.6~8.6 ng/ml组,差异均有统计学意义(P<0.05)。结论:Galectin-3可作为一种评估冠状动脉疾病患者病情程度及预后的标记物,在临床上具有一定的应用价值。
【关键词】 冠状动脉疾病 Galectin-3 心肌梗死 预后
[Abstract] Objective: To explore the value of Galectin-3 in evaluating the occurrence and prognosis of myocardial infarction after coronary artery disease. Method: A total of 50 patients with unstable angina pectoris (the observation group) and 50 patients with stable CAD (the control group) in our hospital from January 2016 to April 2017 were collected. Then the observation group was divided into three groups according to the level of Galectin-3. The correlation between Galectin-3 and the number of vessel branches was analyzed, and the incidence of myocardial infarction and prognosis of each group were followed up. Result: The proportion of smoking patients, diabetes patients, high density lipoprotein, low density lipoprotein and Galectin-3 in the observation group were all higher than those in the control group, the differences were statistically significant (P<0.05). As the number of coronary artery lesions increased, the higher the Galectin-3 level. The level of Galectin-3 of patients with ≥3 vascular lesions1 vascular lesion was higher than those of patients with 2 vascular lesions and 1 vascular lesion, the differences were statistically significant (t=7.32, 11.53, P<0.001), the Galectin-3 level of patients with 1 vascular lesion was higher than that of patients with 1 vascular lesion, the difference was statistically significant (t=8.03, P<0.001). The incidence of myocardial infarction in >8.6 ng/ml group was higher than those in <6.6 ng/ml group, 6.6-8.6 ng/ml group, the differences were statistically significant (P<0.05). The mortality rate in >8.6 ng/ml group was higher than that in <6.6 ng/ml group, 6.6-8.6 ng/ml group, the differences were statistically significant (P<0.05). Conclusion: Galectin-3 can be used as a marker to evaluate the severity and prognosis of patients with coronary artery disease, and it has certain clinical application value.
綜上所述,本研究证实了Galectin-3血清水平与冠状动脉疾病患者的疾病严重程度具有一定的相关性,高水平的Galectin-3表达代表着患者的预后不良,Galectin-3在冠状动脉疾病的诊断、预后评估及靶点治疗中具有一定的应用价值。
参考文献
[1] Hanson M A,Fareed M T,Argenio S L,et al.Coronary artery disease[J].Prim Care,2013,40(1):1-16.
[2] Teramoto T,Sasaki J,Ishibashi S,et al.Coronary artery disease. Executive summary of the Japan Atherosclerosis Society (JAS) guidelines for the diagnosis and prevention of atherosclerotic cardiovascular diseases in Japan - 2012 version[J].J Atheroscler Thromb,2014,21(2):86-92.
[3] Gao R,Yang Y,Han Y,et al.Bioresorbable vascular scaffolds versus metallic stents in patients with coronary artery disease: ABSORB China Trial[J].J Am Coll Cardiol,2015,66(21):2298-309.
[4] Oikonomou E,Tsalamandris S,Karlis D,et al.The association among biomarkers of renal and heart function in patients with heart failure: the role of NGAL[J].Biomark Med,2018,12(12):1323-1330.
[5] van Vark L C,Lesman-Leegte I,Baart S J,et al.Prognostic Value of Serial Galectin-3 Measurements in Patients With Acute Heart Failure[J].J Am Heart Assoc,2017,6(12):e003700.
[6] Besler C,Lang D,Urban D,et al.Plasma and Cardiac Galectin-3 in Patients With Heart Failure Reflects Both Inflammation and Fibrosis: Implications for Its Use as a Biomarker[J].Circ Heart Fail,2017,10(3):e003804.
[7] Farhangi M A,Moradi F,Najafi M,et al.10-y survival in patients who underwent coronary artery bypass grafting surgery in Tehran Heart Center-Coronary Outcome Measurement Study:The powerful predicting ability of the dietary inflammatory index and dietary antioxidant quality[J].Nutrition,2019,63(64):22-28.
[8] Doyle F,Freedland K,Carney R,et al.Network meta-analysis of randomised trials of pharmacological, psychotherapeutic, exercise and collaborative care interventions for depressive symptoms in patients with coronary artery disease: hybrid systematic review of systematic reviews protocol[J].Syst Rev,2019,8(1):71.
[9] Dong R,Zhang M,Hu Q,et al.Galectin-3 as a novel biomarker for disease diagnosis and a target for therapy (Review)[J].Int J Mol Med,2018,41(2):599-614.
[10] Gao N,Yu W Z,Guo N J,et al.Clinical significance of galectin-3 in patients with adult acute myeloid leukemia: a retrospective cohort study with long-term follow-up and formulation of risk scoring system[J].Leuk Lymphoma,2017,58(6):1394-1402.
[11] Chen Y S,Gi W T,Liao T Y,et al.Using the galectin-3 test to predict mortality in heart failure patients: a systematic review and meta-analysis[J].Biomark Med,2016,10(3):329-342.
[12] Desmedt V,Desmedt S,Delanghe J R,et al.Galectin-3 in Renal Pathology: More Than Just an Innocent Bystander[J].Am J Nephrol,2016,43(5):305-317.
[13] Lepojarvi E S,Piira O P,P??kk? E,et al.Serum PINP, PIIINP, galectin-3, and ST2 as surrogates of myocardial fibrosis and echocardiographic left venticular diastolic filling properties[J].Front Physiol,2015,6:200.
[14] Jansen H,Koenig W,Jaensch A,et al.Prognostic Utility of Galectin-3 for recurrent cardiovascular events during Long-term follow-up in patients with stable coronary heart disease: Results of the KAROLA study[J].Clin Chem,2016,62:1372-1379.
[15] Zhang M,Meng Q,Qi X,et al.Comparison of multiple biomarkers for mortality prediction in patients with acute heart failure of ischemic and nonischemic etiology[J].Biomark Med,2018,12(11):1207-1217.
[16] Perea R J,Morales-Ruiz M,Ortiz-Perez J T,et al.Utility of galectin-3 in predicting post-infarct remodeling after acute myocardial infarction based on extracellular volume fraction mapping[J].Int J Cardiol,2016,223:458-464.
(收稿日期:2019-11-21) (本文編辑:马竹君)