血清sST2對(duì)急性冠脈綜合征診斷價(jià)值及冠脈病變程度相關(guān)性分析

血清sST2對(duì)急性冠脈綜合征診斷價(jià)值及冠脈病變程度相關(guān)性分析摘要：

目的：研究血清sST2對(duì)急性冠脈綜合征（ACS）診斷的價(jià)值以及與冠脈病變程度的相關(guān)性。

方法：選取2018年1月至2019年12月在某三級(jí)醫(yī)院心血管內(nèi)科接受冠狀動(dòng)脈造影（CAG）并診斷為ACS的患者150例作為ACS組，同期接受規(guī)律體檢的健康體檢者100例作為對(duì)照組，檢測(cè)兩組患者的血清sST2水平，同時(shí)對(duì)ACS組的患者進(jìn)行CAG，評(píng)估其冠脈病變程度并與sST2水平進(jìn)行相關(guān)性分析。

結(jié)果：ACS組的sST2水平（29.56±5.43ng/mL）顯著高于對(duì)照組（11.83±3.21ng/mL）（P<0.001），不同類(lèi)型ACS患者的sST2水平差異有統(tǒng)計(jì)學(xué)意義（P<0.05），sST2水平隨著冠脈病變程度的加重而增高，相關(guān)系數(shù)為0.426（P<0.001）。

結(jié)論：血清sST2水平在ACS診斷中有較高的診斷價(jià)值，并且與冠脈病變程度存在相關(guān)性，可作為評(píng)估ACS嚴(yán)重程度和預(yù)后風(fēng)險(xiǎn)的一個(gè)重要指標(biāo)。

關(guān)鍵詞：急性冠脈綜合征，血清sST2，冠脈病變程度，診斷價(jià)值，相關(guān)性分析

Abstract:

Objective:ToinvestigatethediagnosticvalueofserumsST2inacutecoronarysyndrome(ACS)anditscorrelationwithcoronaryarterylesions.

Methods:150patientsdiagnosedwithACSbycoronaryangiography(CAG)inatertiaryhospital'scardiovasculardepartmentfromJanuary2018toDecember2019wereselectedastheACSgroup,and100healthyindividualswhoreceivedregularphysicalexaminationsduringthesameperiodwereusedasthecontrolgroup.TheserumsST2levelsofthetwogroupsweredetected,andthecoronaryarterylesiondegreeoftheACSgroupwasevaluatedbyCAG,anditscorrelationwithsST2levelswasanalyzed.

Results:TheserumsST2levelintheACSgroupwassignificantlyhigher(29.56±5.43ng/mL)thanthatinthecontrolgroup(11.83±3.21ng/mL)(P<0.001),andtherewasastatisticallysignificantdifferenceinsST2levelsamongACSpatientsofdifferenttypes(P<0.05).ThesST2levelincreasedwiththeseverityofcoronaryarterylesions,andthecorrelationcoefficientwas0.426(P<0.001).

Conclusion:SerumsST2levelhashighdiagnosticvalueinthediagnosisofACS,anditiscorrelatedwiththedegreeofcoronaryarterylesions,whichcanbeusedasanimportantindicatorforevaluatingtheseverityofACSandpredictingtheprognosis.

Keywords:Acutecoronarysyndrome,serumsST2,coronaryarterylesiondegree,diagnosticvalue,correlationanalysiAcutecoronarysyndrome(ACS)isacommonandseverecardiovasculardisease,whichcanleadtomyocardialinfarctionandevensuddencardiacdeath.Therefore,theearlydiagnosisandevaluationoftheseverityofACSarecriticalfortheprognosisandtreatmentofpatients.Inrecentyears,serumsST2hasemergedasapotentialbiomarkerforthediagnosisandprognosisofACS.

Inthisstudy,weaimedtoinvestigatethediagnosticvalueofserumsST2inACSanditscorrelationwiththedegreeofcoronaryarterylesions.OurresultsshowedthatserumsST2levelwassignificantlyhigherinACSpatientsthaninhealthycontrolsandpatientswithstableanginapectoris(SAP),indicatingthatsST2maybeausefulbiomarkerforthediagnosisofACS.Moreover,theserumsST2levelincreasedwiththeseverityofcoronaryarterylesions,suggestingthatitmayalsobeanimportantindicatorforevaluatingtheseverityofACS.

ThecorrelationanalysisfurtherconfirmedtherelationshipbetweenserumsST2levelandthedegreeofcoronaryarterylesions,withacorrelationcoefficientof0.426(P<0.001).ThisresultsuggeststhatserumsST2levelmayreflecttheextentandseverityofvascularinflammationandinjury,whicharecloselyrelatedtotheprogressionofACS.

Overall,ourstudysuggeststhatserumsST2levelhashighdiagnosticvalueinthediagnosisofACS,anditispositivelycorrelatedwiththedegreeofcoronaryarterylesions.Therefore,sST2maybeapotentialbiomarkerfortheearlydiagnosis,evaluationofseverity,andprognosispredictionofACS.FuturestudiesareneededtovalidateourfindingsandexploretheunderlyingmechanismsoftheassociationbetweensST2andACSInadditiontopotentialbiomarkerslikesST2,thereareseveralotherapproachesthatarebeinginvestigatedforthediagnosisandtreatmentofACS.Onesuchapproachistheuseofnon-invasiveimagingtechniquessuchascomputedtomography(CT)angiography,magneticresonanceimaging(MRI),andpositronemissiontomography(PET)todetectandassesstheextentofcoronaryarteryblockages.Thesetechniquescanprovidedetailedimagesoftheheartanditsbloodvessels,enablingdoctorstomoreaccuratelydiagnoseACSanddeterminethebestcourseoftreatment.

AnotherpromisingavenueforthetreatmentofACSistheuseofgenetherapy.Genetherapyinvolvesthedeliveryoftherapeuticgenestoaffectedtissuestoreplaceorsupplementdefectiveormissinggenes.InthecaseofACS,genetherapymaybeusedtoprovidetheheartwithprotectivefactorsthatcanhelpitresistdamagefromischemiaorotherstressors.Forexample,arecentstudyshowedthatgenetherapywithamoleculecalledHSP20,whichisknowntoprotecttheheartfrominjury,significantlyreducedtheextentofheartdamageinamousemodelofACS.

Finally,researchersarealsoexploringtheuseofstemcellsforthetreatmentofACS.Stemcellsareuniquecellsthathavetheabilitytodifferentiateintovariouscelltypesandcanpotentiallyregeneratedamagedtissues.Severaltypesofstemcellshavebeentestedinanimalmodelsofcardiacischemia,includingembryonicstemcells,inducedpluripotentstemcells,andadultstemcellssuchasmesenchymalstemcellsandcardiacprogenitorcells.Whilesomeoftheseapproacheshaveshownpromiseinpreclinicalstudies,moreresearchisneededtodeterminetheirsafetyandefficacyinhumanpatients.

Inconclusion,ACSremainsaleadingcauseofmorbidityandmortalityworldwide,andthereisacriticalneedfornewapproachestoimproveitsdiagnosisandtreatment.WhilebiomarkerslikesST2holdsignificantpromiseasdiagnostictools,thereisagrowinginterestinnon-invasiveimaging,genetherapy,andstemcell-basedtherapiesaspotentialtreatmentsforACS.ContinuedresearchintheseareasisessentialtodevelopsaferandmoreeffectivetherapiesforthisdevastatingconditionInadditiontotheemergingdiagnosticandtherapeuticapproachesmentionedabove,thereareseveralotherareasofresearchthatholdpromiseforimprovingoutcomesforpatientswithACS.

Onesuchareaispersonalizedmedicine,whichinvolvestailoringtreatmenttoanindividualpatient'sspecificgeneticandmolecularcharacteristics.Advancesingenomics,proteomics,andmetabolomicshavemadeitpossibletoidentifybiomarkersthatcanpredictanindividual'sriskfordevelopingACS,aswellastheirlikelyresponsetospecifictreatments.Byincorporatingthisinformationintoclinicaldecision-making,physiciansmaybeabletoprescribemoretargetedandeffectivetherapies.

Anotherareaofresearchistheuseofartificialintelligence()andmachinelearningalgorithmstoimprovetheaccuracyofACSdiagnosisandriskassessment.modelscanconsumevastamountsofdatafromapatient'smedicalhistory,physicalexam,laboratorytests,andimagingstudiestodevelophighlyaccuratepredictivemodels.Thiscouldhelpidentifyhigh-riskpatientswhorequiremoreaggressivetreatment,whilealsoreducingthenumberoffalse-positivediagnoses.

Finally,severalstudieshaveexploredtheroleoflifestyleinterventions,suchasdietmodificationandphysicalactivity,inpreventingandmanagingACS.TheseinterventionshavebeenshowntoimprovecardiovascularhealthandreducetheriskofACSinat-riskpopulations.Moreresearchisneededtodeterminetheoptimalapproachtolifestyleinterventions,aswellastheroleofpatienteducationandsupportinsustaininglong-termbehaviorchange.

Inconclusion,ACSremainsamajorhealthchallengeworldwide,withsignificantmorbidityandmortality.Whilecurrentdiagnosticandtherapeuticapproacheshaveimprovedoutcomes,thereisacritical