血清Sestrin2在急性ST段抬高型心肌梗死中的表达及其与缺血再灌注损伤的关系

doi:10.11958/20220813

摘要/Abstract

摘要： Objective To investigate the expression of serum Sestrin2 in acute ST-segment elevation myocardial infarction (STEMI) and its relationship with ischemia-reperfusion injury (IRI). Methods A total of 124 STEMI patients were selected as the STEMI group, and they were divided into the IRI group (72 cases) and the non-IRI group (52 cases) according to whether IRI occurred after surgery. Another 50 healthy volunteers were selected as the control group. Serum levels of Sestrin2, malondialdehyde (MDA) and superoxide dismutase (SOD) were detected in all subjects. Pearson's method was used to analyze the correlation between serum Sestrin2 and other indicators in STEMI patients. Multivariate Logistic regression analysis was used to analyze the risk factors of IRI in STEMI patients. The receiver operating characteristic curve (ROC) was used to analyze the predictive value of relevant indicators for the occurrence of IRI in STEMI patients. Results The serum levels of Sestrin2 and MDA were significantly higher in the STEMI group than those in the control group, and the serum level of SOD was significantly lower than that in the control group (P<0.01). The serum levels of Sestrin2, MDA and cardiac troponin (cTnI) were significantly higher in the IRI group than those of the non-IRI group, and the serum SOD level was significantly lower than that of the non-IRI group (P<0.01). Serum Sestrin2 level was positively correlated with MDA level in STEMI patients, and it was negatively correlated with serum SOD level (P<0.05). Multivariate Logistic regression analysis showed that high serum levels of Sestrin2 and MDA were risk factors for IRI in STEMI patients, while high SOD level was protective factors (P<0.05). The ROC analysis showed that the areas under the curve of serum Sestrin2, MDA and SOD for predicting the risk of IRI in STEMI patients were 0.759 (95%CI: 0.673-0.845), 0.654 (95%CI: 0.557-0.751) and 0.671 (95% CI: 0.575-0.767), respectively, and serum Sestrin2 had the highest predictive value. Conclusion The expression of Sestrin2 is abnormally high in STEMI patients, and its expression level is closely related to the occurrence of IRI in patients.

关键词: ST段抬高型心肌梗死, 急性病, 再灌注损伤, 氧化性应激, 早期诊断, Sestrin2

Key words: ST elevation myocardial infarction, acute disease, reperfusion injury, oxidative stress, early diagnosis, Sestrin2

中图分类号:

R542.2+2

图/表 5

参考文献 17

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组别	n	Sestrin2（μg/L）	MDA（μmol/L）	SOD（U/L）
对照组	50	6.53±2.01	3.97±1.05	98.87±15.87
STEMI组	124	10.36±3.18	5.32±1.56	72.32±13.12
t		7.896^＊＊	5.622^＊＊	11.354^＊＊

组别	n	Sestrin2（μg/L）	MDA（μmol/L）	SOD（U/L）
对照组	50	6.53±2.01	3.97±1.05	98.87±15.87
STEMI组	124	10.36±3.18	5.32±1.56	72.32±13.12
t		7.896^＊＊	5.622^＊＊	11.354^＊＊

组别		n	性别（男/女）			年龄（岁）			体质量指数（kg/m²）			高血压
非IRI组		52	32/20			57.17±8.51			22.12±1.49			31（59.62）
IRI组		72	44/28			59.01±8.76			22.19±1.61			46（63.89）
χ²或t			0.002			1.168			0.246			0.234
组别	糖尿病			高脂血症			心绞痛史			发病到治疗时间（h）				D to B （min）
非IRI组	10（19.23）			19（36.54）			15（28.85）			3.32±1.09				50.34±8.62
IRI组	18（25.00）			28（38.89）			24（33.33）			3.69±1.28				53.04±9.25
χ²或t	0.575			0.071			0.282			1.688				1.650
组别	cTnI （μg/L）				LVEF			Sestrin2 （μg/L）			MDA （μmol/L）		SOD （U/L）
非IRI组	19.86±4.52				0.63±0.07			7.84±2.67			4.53±1.29		79.95±14.96
IRI组	24.75±6.42				0.61±0.06			12.18±3.39			5.89±1.62		66.81±12.18
χ²或t	4.711^＊＊				1.707			7.670^＊＊			5.012^＊＊		5.383^＊＊

组别		n	性别（男/女）			年龄（岁）			体质量指数（kg/m²）			高血压
非IRI组		52	32/20			57.17±8.51			22.12±1.49			31（59.62）
IRI组		72	44/28			59.01±8.76			22.19±1.61			46（63.89）
χ²或t			0.002			1.168			0.246			0.234
组别	糖尿病			高脂血症			心绞痛史			发病到治疗时间（h）				D to B （min）
非IRI组	10（19.23）			19（36.54）			15（28.85）			3.32±1.09				50.34±8.62
IRI组	18（25.00）			28（38.89）			24（33.33）			3.69±1.28				53.04±9.25
χ²或t	0.575			0.071			0.282			1.688				1.650
组别	cTnI （μg/L）				LVEF			Sestrin2 （μg/L）			MDA （μmol/L）		SOD （U/L）
非IRI组	19.86±4.52				0.63±0.07			7.84±2.67			4.53±1.29		79.95±14.96
IRI组	24.75±6.42				0.61±0.06			12.18±3.39			5.89±1.62		66.81±12.18
χ²或t	4.711^＊＊				1.707			7.670^＊＊			5.012^＊＊		5.383^＊＊

指标	β	SE	Wald χ²	P	OR	OR95%CI
cTnI	0.267	0.201	1.765	0.184	1.306	0.881~1.937
Sestrin2	0.542	0.186	8.491	0.004	1.719	1.194~2.476
MDA	0.368	0.174	4.473	0.034	1.445	1.027~2.032
SOD	-0.645	0.248	6.764	0.009	0.525	0.323~0.853
常数项	0.205	0.103	3.961	0.047	1.228	-