冠心病患者血清DKK3、FGF2水平与血小板活化状态及预后的关系

    The relationship between serum DKK3 and FGF2 with platelet activation and prognosis in patients with coronary heart disease

      摘要
    • 摘要:
      目的  探讨冠心病（CHD）患者血清Dickkopf相关蛋白3（DKK3）、成纤维细胞生长因子2（FGF2）水平与血小板活化状态及预后的关系，并分析二者对主要不良心血管事件（MACE）发生的预测效能。
      方法 入选2023年10月～2024年3月在本院接受经皮冠状动脉介入（PCI）治疗的180例CHD患者为CHD组，同期入选在本院行健康体检的120例志愿者为对照组。ELISA法检测血清DKK3、FGF2水平；Pearson相关性分析CHD患者血清DKK3、FGF2与血小板活化状态指标的关系；Logistic回归分析CHD患者发生MACE的影响因素；ROC曲线评估血清DKK3、FGF2对CHD患者发生MACE的预测效能。
      结果 CHD组患者α-颗粒膜糖蛋白（CD62p）、溶酶体膜糖蛋白（CD63）及血清FGF2水平显著高于对照组，血清DKK3水平显著低于对照组（均P<0.01）；与心功能Ⅱ级组比较，心功能Ⅲ级组患者CD62p、CD63及血清FGF2水平显著升高，血清DKK3水平显著降低（均P<0.01）。CHD患者血清DKK3与CD62p、CD63呈负相关（均P<0.01），血清FGF2与CD62p、CD63呈正相关（均P<0.01）。MACE组患者CD62p、CD63及血清FGF2水平显著高于非MACE组，血清DKK3水平显著低于非MACE组（均P<0.01）。CD62p、CD63以及血清DKK3、FGF2是影响CHD患者发生MACE的因素（均P<0.05）。血清DKK3、FGF2联合预测CHD患者发生MACE的AUC为0.925，联合检测的预测效能更佳（Z二者联合-DKK3=2.486、Z二者联合-FGF2=2.086，P<0.05）。
      结论 CHD患者血清DKK3水平降低，FGF2水平升高，二者与血小板活化状态及预后密切相关，其联合在预测MACE发生方面的价值较高。

       

      Abstract:
      AIM  To investigate the relationship between serum Dickkopf related protein 3 (DKK3) and fibroblast growth factor 2 (FGF2) with platelet activation and prognosis in patients with coronary heart disease (CHD), and to analyze their predictive power for major adverse cardiovascular events (MACE).
      METHODS  From October 2023 to March 2024, 180 CHD patients who underwent percutaneous coronary intervention (PCI) in our hospital were recruited as the CHD group. In the meantime, 120 volunteers who underwent health examinations at our hospital were recruited as control group. ELISA was used to detect serum DKK3 and FGF2. Pearson correlation was applied to explore the relationship between serum DKK3, FGF2 with platelet activation indicators in CHD patients. Logistic regression was performed to explore the influencing factors of MACE in CHD patients. ROC curve was adopted to evaluate the predictive efficacy of serum DKK3 and FGF2 for MACE in CHD patients.
      RESULTS  The levels of α - granule membrane glycoprotein (CD62p), lysosomal membrane glycoprotein (CD63), and serum FGF2 in CHD patients were significantly higher than those in the control group, while the level of serum DKK3 was significantly lower than that in the control group (all P<0.01); Compared with the heart function level II group, the levels of CD62p, CD63, and serum FGF2 in the heart function level III group were significantly increased, while the level of serum DKK3 was significantly decreased (all P<0.01). Serum DKK3 was negatively correlated with CD62p and CD63 in CHD patients (both P<0.01), while serum FGF2 was positively correlated with CD62p and CD63 (both P<0.01). The levels of CD62p, CD63, and serum FGF2 in the MACE group were significantly higher than those in the non MACE group, while the level of serum DKK3 was significantly lower than that in the non MACE group (all P<0.01). CD62p, CD63, as well as serum DKK3 and FGF2, are factors that affect the occurrence of MACE in CHD patients (all P<0.05). The AUC of predicting MACE in CHD patients by combining serum DKK3 and FGF2 was 0.925, and the predictive power of the combined detection was better (Z combined - DKK3=2.486, Z combined - FGF2=2.086, P<0.05).
      CONCLUSION  Serum DKK3 decreases while FGF2 increases in CHD patients. The two are closely related to platelet activation and prognosis, and their union has high value in predicting MACE.

       

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