分泌性白细胞蛋白酶抑制剂与急性冠脉综合征的关系

doi:10.16138/j.1673-6087.2021.04.006

摘要/Abstract

摘要：

目的：探究分泌性白细胞蛋白酶抑制剂（secretory leukocyte protease inhibitor,SLPI）与急性冠脉综合征的关系。方法：选取2018年7月至2020年9月于上海交通大学医学院附属瑞金医院行冠状动脉（冠脉）造影的243例急性冠脉综合征患者与242例性别、年龄构成无显著差异的冠脉正常者。采用酶联免疫吸附法检测血清SLPI水平,并评价血清SLPI水平与急性冠脉综合征的相关性。免疫荧光检测室壁瘤组织中SLPI的细胞定位。结果：急性冠脉综合征患者血清SLPI水平显著高于冠脉正常者[（452.0±167.6） ng/L 比（420.5±154.3） ng/L,P=0.032],多因素Logistic回归分析表明血清SLPI水平升高是急性冠脉综合征的独立危险因素[优势比（odds ratio,OR）=1.309,95%置信区间（confidence interval,CI）：1.040~1.648,P=0.022]。免疫荧光显示在室壁瘤组织中SLPI与平滑肌细胞标志物α平滑肌肌动蛋白（α-smooth muscle actin,α-SMA）共表达。结论：血清SLPI水平是急性冠脉综合征的独立危险因素,且SLPI在室壁瘤组织的平滑肌细胞中表达。

关键词: 急性冠脉综合征, 分泌性白细胞蛋白酶抑制剂, 室壁瘤

Abstract:

Objective To explore the relationship between secretory leukocyte protease inhibitor (SLPI) and acute coronary syndrome (ACS). Methods A total of 243 patients with ACS and 242 age- and gender- matched individuals with normal coronary arteries undergoing coronary angiography from July 2018 to September 2020 in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were enrolled. The serum SLPI level was detected by enzyme-linked immunosorbent assay, and the correlation between serum SLPI level and ACS was evaluated. Immunofluorescence was used to detect the localization of SLPI in ventricular aneurysm. Results The serum SLPI level in ACS patients was significantly higher than that in healthy controls [(452.0±167.6) ng/L vs. (420.5±154.3) ng/L, P=0.032]. Multivariate Logistic regression analysis showed that the increased serum SLPI level was an independent risk factor for ACS [odds ratio(OR)=1.309, 95% confidence interval (CI):(1.040-1.648), P=0.022]. Immunofluorescence showed SLPI was co-expressed with alpha-smooth muscle actin (α-SMA) in the ventricular aneurysm. Conclusions Serum SLPI level is an independent risk factor for ACS, and SLPI is expressed in smooth muscle cell of ventricular aneurysm.

Key words: Acute coronary syndrome, Secretory leukocyte protease inhibitor, Ventricular aneurysm

中图分类号:

R543.3

金姚, 黄晖, 吴志俊. 分泌性白细胞蛋白酶抑制剂与急性冠脉综合征的关系[J]. 内科理论与实践, 2021, 16(04): 251-254.

JIN Yao, HUANG Hui, WU Zhijun. Relationship between secretory leukocyte protease inhibitor and acute coronary syndrome[J]. Journal of Internal Medicine Concepts & Practice, 2021, 16(04): 251-254.

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项目	对照组（n=242）	观察组（n=243）	t/χ²	P
男性[n(%)]	153(63.2)	169(69.6)	2.173	0.140
年龄(岁)	60.5±9.8	61.8±12.7	1.285	0.199
BMI (kg/m²)	24.77±3.37	24.98±5.13	0.541	0.589
收缩压(mmHg)	133.5±18.3	132.1±19.8	-0.818	0.414
舒张压(mmHg)	75.7±12.3	76.4±13.1	0.659	0.510
空腹血糖(mmol/L)	5.67±1.16	7.07±2.90	6.861	<0.001
HDL-C (mmol/L)	1.19±0.32	1.06±0.26	-4.925	<0.001
LDL-C (mmol/L)	3.30±11.59	3.06±1.04	-0.331	0.741
三酰甘油(mmol/L)	1.59±1.04	1.82±1.26	2.124	0.034
eGFR[mL/(min·1.73m²)]	87.8±13.7	86.3±15.5	-1.143	0.254
hsCRP (mg/L)	3.18±12.02	15.39±31.32	5.383	<0.001
SLPI (ng/L)	420.5±154.3	452.0±167.6	2.155	0.032

项目	β	SE	Wald χ²	OR（95% CI）	P
性别	0.411	0.299	1.881	1.508（0.838~2.712）	0.170
年龄（四分位）	0.186	0.166	1.266	1.205（0.871~1.666）	0.260
BMI（四分位）	-0.210	0.130	2.601	0.811（0.628~1.046）	0.107
收缩压（四分位）	-0.034	0.144	0.056	0.967（0.729~1.282）	0.814
舒张压（四分位）	-0.078	0.144	0.291	0.925（0.698~1.227）	0.590
空腹血糖（四分位）	0.351	0.128	7.489	1.421（1.105~1.827）	0.006
HDL-C（四分位）	-0.311	0.148	4.452	0.732（0.548~0.978）	0.035
LDL-C（四分位）	0.521	0.120	18.71	1.684（1.330~2.132）	<0.001
三酰甘油（四分位）	-0.150	0.142	1.116	0.861（0.652~1.137）	0.291
eGFR（四分位）	-0.058	0.145	0.161	0.943（0.709~1.254）	0.689
hsCRP（四分位）	1.121	0.135	68.77	3.067（2.353~3.997）	<0.001
SLPI（四分位）	0.269	0.117	5.250	1.309（1.040~1.648）	0.022