血浆内皮素1水平对稳定性冠心病患者的预后价值探讨

摘要

Objective To study the value of endothelin-1 (ET-1) in predicting the outcome of stable coronary artery disease (SCAD) patients.Methods A total of 3154 SCAD patients who were followed up for 24 months were divided into cardiocerebral vascular events group (n=189) and cardiocerebral vascular events-free group (n =2965).Their serum ET-1 level was measured by ELISA.The patients were further divided into ET-1 ＜0.3 pmol/L group (n=1588) and ET-1≥0.3 pmol/L group (n=1566).The value of ET-1 in predicting the end events was assessed by Cox regression analysis.The survival curve was plotted by Kaplan-Meier analysis.Results The serum ET-1 level was signify-cantly higher in cardiocerebral vascular events group than in cardiocerebral vascular events-free group (0.33 pmol/L vs 0.30 pmol/L,P=0.004).The incidence of clinical end events was significantly lower in ET-1 ≥0.3 pmol/L group than in ET-1 ＜0.3 pmol/L group (7.02％ vs 4.97％,P=0.015).Multivariable Cox regression analysis showed that ET-1 was a predictor of clinical end events (HR=1.656,95％CI:1.099-2.496,P=0.016).Kaplan-Meier analysis showed that the events-free survival rate was lower in patients with a higher serum ET-1 level than in those with a lower serum ET-1 level (P=0.016).Conclusion ET-1 is an important risk factor for the outcome of SCAD patients.Further studies are needed to confirm its long-term value in predicting the outcome of SCAD patients.%目的 研究血浆内皮素1(big endothelin-1,ET-1)对稳定性冠心病(SCAD)远期预测价值.方法 连续入选3154例SCAD患者,并随访24个月,随访期间,将发生心脑血管事件的189例为事件组,未发生心脏血管事件的2965例为非事件组.酶联免疫吸附法测定基线ET-1水平,将ET-1＜0.3 pmol/L为低ET-1组1588例,ET-1≥0.3 pmol/L为高ET-1组1 566例.应用Cox回归分析评价ET-1水平对终点事件的预测价值,应用Kaplan-Meier 法绘制生存曲线.结果 事件组ET-1水平较非事件组明显升高[0.33(0.25,0.49)pmol/L vs 0.30(0.22,0.45)pmol/L,P=0.004].高ET-1组临床终点事件发生率明显高于低ET-1组(7.02％ vs 4.97％,P=0.015).多因素Cox回归分析显示,ET-1为临床终点事件的预测因素(HR=1.656,95％CI:1.099～2.496,P=0.016).Kaplan-Meier分析显示,高ET 1组无事件生存率较低ET-1组降低(P=0.016).结论 ET-1为SCAD患者预后的重要危险因素,其预后判断的长期作用有待进一步研究证实.