| 摘要: |
| ［摘要］ 目的 分析信号肽-CUB-表皮生长因子结构域包含蛋白1（SCUBE1）、整合素αvβ3在冠心病（CHD）患者血清中的表达与经皮冠状动脉介入（PCI）术后氯吡格雷敏感程度的关联性。方法 招募2022年3月至2023年9月三亚中心医院收治的CHD患者164例（CHD组），另选取同期健康体检者150名（对照组）。根据血小板聚集抑制率（IPA），将CHD患者分为低敏感组（41例，IPA<20%）和高敏感组（123例，IPA≥20%）。采用酶联免疫吸附试验检测对照组体检当天和CHD组PCI术前、术后即刻和术后48 h的血清SCUBE1、αvβ3水平。采用多因素logistic回归分析影响CHD患者PCI术后氯吡格雷敏感程度下降的因素。采用受试者工作特征（ROC）曲线分析CHD患者术前血清SCUBE1、αvβ3水平预测PCI术后氯吡格雷敏感程度下降的效能。结果 CHD组PCI术前、术后即刻、术后48 h的血清SCUBE1、αvβ3水平均显著高于对照组（P<0.05），且术后血清SCUBE1、αvβ3水平均呈上升趋势，组内各时间点间比较差异有统计学意义（P<0.05）。低敏感组PCI术前、术后即刻、术后48 h的血清SCUBE1、αvβ3水平均高于高敏感组，差异有统计学意义（P<0.05）。多因素logistic回归分析结果显示，PCI术前较高的PLT［OR(95%CI)=2.693（1.182～6.134）］、MPV［OR(95%CI)=2.285（1.328～3.933）］、SCUBE1［OR(95%CI)=2.571（1.352～4.890）］和αvβ3［OR(95%CI)=3.254（1.113～7.340）］水平是促进PCI术后氯吡格雷敏感程度下降的独立危险因素（P<0.05）。ROC曲线分析结果显示，PCI术前血清SCUBE1、αvβ3水平均可有效预测CHD患者术后氯吡格雷敏感程度下降，且二者联合的预测效能更高［AUC(95%CI)=0.899(0.842～0.940)］，灵敏度和特异度分别为72.61%和94.31%。结论 CHD患者血清SCUBE1、αvβ3水平升高，且PCI术前血清SCUBE1、αvβ3水平可有效预测术后氯吡格雷敏感程度下降，值得临床医师关注。 |
| 关键词: 冠心病 经皮冠状动脉介入 氯吡格雷 信号肽-CUB-表皮生长因子结构域包含蛋白1 整合素αvβ3 |
| DOI：10.3969/j.issn.1674-3806.2025.01.08 |
| 分类号:R 541.4；R 446 |
| 基金项目:海南省自然科学基金资助项目（编号：822RC873） |
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| Analysis on the correlation of serum SCUBE1 and αvβ3 expressions with sensitivity to clopidogrel after PCI surgery in patients with coronary heart disease |
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CHEN Juan1, WANG Xiaoli1, WU Shuhua2, YUAN Yongcheng3, QIN Jiangjun4
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1.Department of Pharmacy, Sanya Central Hospital(Hainan Third People′s Hospital), Sanya 572000, China; 2.Drug Clinical Trial Institution, Sanya Central Hospital(Hainan Third People′s Hospital), Sanya 572000, China; 3.Department of Cardiology, Sanya Central Hospital(Hainan Third People′s Hospital), Sanya 572000, China; 4.Department of Radiology, Sanya Central Hospital(Hainan Third People′s Hospital), Sanya 572000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the expressions of signal peptide-CUB-EGF-like domain-containing protein 1(SCUBE1) and integrin αvβ3 in the serum of patients with coronary heart disease(CHD), and to analyze the correlation between these expressions and sensitivity to clopidogrel after percutaneous coronary intervention(PCI) surgery. Methods A total of 164 CHD patients admitted to Sanya Central Hospital from March 2022 to September 2023 were recruited as CHD group, and 150 healthy individuals undergoing physical examination during the same period were selected as control group. According to inhibition rate of platelet aggregation(IPA), the CHD patients were divided into low-sensitive group(41 cases, IPA<20%) and high-sensitive group(123 cases, IPA≥20%). Enzyme-linked immunosorbent assay(ELISA) was used to detect serum SCUBE1 and αvβ3 levels in the control group on the day of physical examination and in the CHD group before PCI surgery, immediately after PCI surgery, and 48 hours after PCI surgery. Multivariate logistic regression was used to analyze the factors affecting the decrease of clopidogrel sensitivity in the CHD patients after PCI surgery. Receiver operating characteristic(ROC) curve was used to analyze the predictive efficiency of preoperative serum SCUBE1 and αvβ3 levels for the decrease of clopidogrel sensitivity in the CHD patients after PCI surgery. Results The serum SCUBE1 and αvβ3 levels before PCI surgery, immediately after PCI surgery, and 48 hours after PCI surgery in the CHD group were significantly higher than those in the control group(P<0.05), and the postoperative serum SCUBE1 and αvβ3 levels showed an upward trend, and the differences in intra-group comparisons between different time points were statistically significant(P<0.05). The serum SCUBE1 and αvβ3 levels before PCI surgery, immediately after PCI surgery, and 48 hours after PCI surgery in the low-sensitive group were higher than those in the high-sensitive group, and the differences were statistically significant between the two groups(P<0.05). The results of multivariate logistic regression analysis showed that preoperative higher levels of platelet(PLT)［OR(95%CI)=2.693(1.182-6.134)］, mean platelet volume(MPV)［OR(95%CI)=2.285(1.328-3.933)］, SCUBE1［OR(95%CI)=2.571(1.352-4.890)］, and αvβ3［OR(95%CI)=3.254(1.113-7.340)］ were independent risk factors for promoting the decrease in sensitivity to clopidogrel after PCI surgery(P<0.05). The results of ROC curve analysis showed that both serum SCUBE1 and αvβ3 levels before surgery could effectively predict the decrease of clopicogrel sensitivity in the CHD patients after PCI surgery, and the combined predictive efficiency of the two indicators was higher［AUC(95%CI)=0.899(0.842-0.940)］, with sensitivity of 72.61% and specificity of 94.31%. Conclusion The serum SCUBE1 and αvβ3 levels of CHD patients increase, and preoperative serum SCUBE1 and αvβ3 levels can effectively predict the decrease of clopidogrel sensitivity after PCI surgery, which is worth the attention of clinicians. |
| Key words: Coronary heart disease(CHD) Percutaneous coronary intervention(PCI) Clopidogrel Signal peptide-CUB-EGF-like domain-containing protein 1(SCUBE1) Integrin αvβ3 |
