【摘要】 目的 探讨血清半乳糖凝聚素-3(Gal-3)、分泌型卷曲蛋白5(SFRP5)、心型脂肪酸结合蛋白（H-FABP）联合检测对冠状动脉粥样硬化性心脏病（冠心病）患者预后评估的临床价值。方法 选择2020年1月至2022年6月于郑州大学第一附属医院心内科就诊的83例冠心病患者作为病例组，根据冠心病类型将其分为稳定型心绞痛组（n=21），不稳定型心绞痛组（n=45）和心肌梗死组（n=17）；根据临床随访，记录心源性死亡、心肌梗死、病变血管再狭窄以及支架血栓等将患者分为预后不良组（n=18）和预后良好组（n=65）。另选择同期我院进行体检的50例健康人群作为对照组，分析两组血清Gal-3、SFRP5、H-FABP水平变化情况及其临床价值。结果 病例组患者血清SFRP5水平显著低于对照组，Gal-3、H-FABP水平均显著高于对照组，差异有统计学意义（P<0.05）。稳定型心绞痛组Gal-3、H-FABP水平均显著低于不稳定型心绞痛组和心肌梗死组，SFRP5水平显著高于不稳定型心绞痛组和心肌梗死组。不稳定型心绞痛组Gal-3、H-FABP水平均显著低于心肌梗死组；SFRP5水平显著高于心肌梗死组，差异具有统计学意义（P<0.05）。预后不良组血清SFRP5水平均显著低于预后良好组，Gal-3、H-FABP水平均显著高于预后良好组，差异具有统计学意义（P<0.05）。ROC曲线分析结果显示，血清Gal-3预测冠心病患者不良预后的AUC为0.779，灵敏度为63.43%，特异度为67.40%，截断值为59.54 ng/L。血清SFRP5预测冠心病患者不良预后的AUC为0.963，灵敏度为81.40%，特异度为70.00%，截断值为4.87 mg/L；血清H-FABP预测冠心病患者不良预后的AUC为0.830，灵敏度为73.50%，特异度为69.00%，截断值为17.46 ng/ml，联合检测的特异度、准确度较单独检测更高（P<0.05）。结论 冠心病患者血清中Gal-3、SFRP5、H-FABP的表达异常，在冠心病不良预后中具有一定的诊断价值，同时也为靶向药物的治疗提供了新思路。更多还原

【Abstract】 Objective To investigate the clinical value of combined detection of of galectin-3(Gal-3),secretory frizzin 5(SFRP5) and heart-type fatty acid-binding protein(H-FABP) to prognosis evaluation in patients with coronary heart disease(CHD). Methods CHD patients(n=83) were chosen from First Affiliated Hospital of Zhengzhou University from Jan. 2020 to June 2022. CHD patients as case group were divided, according to CHD types, into stable angina pectoris group(SAP group, n=21), unstable angina pectoris group(UAP group, n=45)and myocardial infarction group(MI group, n=17). According to clinical follow-up, CHD patients were divided into poor prognosis group(n=18) and good prognosis group(n=65). Meanwhile the healthy persons with physical examinations(n=50) were chosen into control group. The changes and clinical value of levels of Gal-3, SFRP5 and H-FABP were analyzed in 2 groups. Results SFRP5 level was significantly lower and levels of Gal-3 and H-FABP were significantly higher in case group than those in control group(P<0.05). The levels of Gal-3 and H-FABP were significantly lower and SFRP5 level was significantly higher in SAP group than those in UAP group and MI group. The levels of Gal-3 and H-FABP were significantly lower and SFRP5 level was significantly higher in UAP group than those in MI group(P<0.05). SFRP5 level was significantly lower and levels of Gal-3 and H-FABP were significantly higher in poor prognosis group than those in good prognosis group(P<0.05). The results of ROC curve analysis showed that in predicting poor prognosis AUC of serum Gal-3 was 0.779, sensitivity was 63.43%,specificity was 67.40% and cutoff value was 59.54 ng/L, AUC of serum SFRP5 was 0.963, sensitivity was 81.40%,specificity was 70.00% and cutoff value was 4.87 mg/L, and AUC of serum H-FABP was 0.830, sensitivity was 73.50%, specificity was 69.00% and cutoff value was 17.46ng/mL. The specificity and accuracy of combined detection of Gal-3, SFRP5 and H-FABP were higher than those of single detection of Gal-3, SFRP5 or H-FABP(P<0.05). Conclusion The abnormal expressions of serum Gal-3, SFRP5 and H-FABP have certain diagnostic value to poor prognosis in CHD patients, which provides a new idea for targeted drug therapy.更多还原