血清sST2对急性冠脉综合征诊断价值及冠脉病变程度相关性分析

血清sST2对急性冠脉综合征诊断价值及冠脉病变程度相关性分析摘要：

目的：研究血清sST2对急性冠脉综合征（ACS）诊断的价值以及与冠脉病变程度的相关性。

方法：选取2018年1月至2019年12月在某三级医院心血管内科接受冠状动脉造影（CAG）并诊断为ACS的患者150例作为ACS组，同期接受规律体检的健康体检者100例作为对照组，检测两组患者的血清sST2水平，同时对ACS组的患者进行CAG，评估其冠脉病变程度并与sST2水平进行相关性分析。

结果：ACS组的sST2水平（29.56±5.43ng/mL）显著高于对照组（11.83±3.21ng/mL）（P<0.001），不同类型ACS患者的sST2水平差异有统计学意义（P<0.05），sST2水平随着冠脉病变程度的加重而增高，相关系数为0.426（P<0.001）。

结论：血清sST2水平在ACS诊断中有较高的诊断价值，并且与冠脉病变程度存在相关性，可作为评估ACS严重程度和预后风险的一个重要指标。

关键词：急性冠脉综合征，血清sST2，冠脉病变程度，诊断价值，相关性分析

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