血清可溶性CD40L对急性冠状动脉综合症预后判断的临床意义

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目的探讨检测血清sCD40L对急性冠状动脉综合征(ACS)预后的判断价值。方法检测并比较132例急性冠状动脉综合征患者(ACS组)与120名健康成人(健康对照组)的血清sCD40L水平,并随访记录1年内所有急性冠状动脉综合征患者再次心血管事件发生情况,以血清sCD40L水平为标准,将所有观察对象平均分为四组,比较分析各组急性冠状动脉患者心血管事件再次发生的差异,同时应用ROC曲线分析血清sCD40L水平对急性冠状动脉患者心血管事件再次发生的预测能力。结果 ACS组患者血清sCD40L水平显著高于健康对照组(P<0.05)。随访结果表明随着各组血清sCD40L水平升高,心血管事件再次频率以及严重程度显著增加,血清sCD40L水平预测急性冠状动脉综合症再次发生心血管事件曲线下面积为0.718,其血清sCD40L水平最佳临界值为7.13 ng/L,预测的灵敏度和特异性分别为70.60%和65.10%。预测死亡病例发生的曲线下面积为0.703,其血清sCD40L水平最佳临界值为6.36 ng/L,预测的灵敏度和特异性分别为100%和32.0%。结论检测血清sCD40L水平对ACS患者预后的判断有一定临床价值。 Objective To investigate the value of serum sCD40L in predicting the prognosis of acute coronary syndrome (ACS). Methods The serum levels of sCD40L in 132 patients with acute coronary syndrome (ACS group) and 120 healthy adults (control group) were detected and compared. The incidence of recurrent cardiovascular events in all patients with acute coronary syndrome within one year was recorded. The level of serum sCD40L as a standard, all the observation objects were divided into four groups, comparative analysis of acute coronary patients in each group recurrence of cardiovascular events, while the application of ROC curve analysis of serum sCD40L levels in patients with acute coronary events again The predictive ability that occurs. Results Serum levels of sCD40L in ACS patients were significantly higher than those in healthy controls (P <0.05). The follow-up results showed that with the increase of serum sCD40L level in each group, the frequency and severity of cardiovascular events increased significantly. The level of sCD40L in serum of patients with acute coronary syndrome predicted by sCD40L level was 0.718, and the serum sCD40L level was the best The cut-off value was 7.13 ng / L, with a predicted sensitivity and specificity of 70.60% and 65.10%, respectively. The predicted area under the curve of death was 0.703. The best cutoff value of serum sCD40L level was 6.36 ng / L. The predicted sensitivity and specificity were 100% and 32.0% respectively. Conclusion The detection of serum sCD40L levels in the prognosis of ACS patients have some clinical value.
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