血清可溶性CD147的含量与冠状动脉粥样硬化性心脏病发病风险的关联分析

目的：探讨血清可溶性CD147（sCD147）的含量与冠状动脉粥样硬化性心脏病（CAHD）发病风险的关系并初步探讨其临床应用价值。方法：收集130例CAHD（包括50例稳定性心绞痛（SAP）、46例不稳定性心绞痛（UAP）、34例急性心肌梗死（AMI））和130例年龄、性别与冠心病患者相匹配的健康志愿者的外周血样本,应用双抗体夹心ELISA检测各组血清sCD147的表达水平,比较分析血清sCD147水平与CAHD的临床相关性,并绘制研究对象工作特征（ROC）曲线。结果：CAHD患者血清sCD147含量（AMI、UAP及SAP组中位数分别为3.35μg·L-1、2.72μg·L-1和2.66μg·L-1）显著高于对照组（中位数为1.64μg·L-1,P〈0.001）,其中AMI组明显高于UAP及SAP组（P值分别为0.008、0.006）。血清sCD147含量与CAHD患者TG、LDL-C及AIP显著正相关（P值分别为0.021、0.035及0.039）。以健康对照为参照,与sCD147含量低的个体相比,sCD147含量高的个体CAHD发病风险显著上升（校正比值比为2.18;95%可信区间为1.49-2.96）,且高的sCD147含量与CAHD发病风险之间存在显著的剂量依赖关系（P〈0.001）。用血清sCD147含量绘制ROC曲线,曲线下面积为0.761（95%可信区间为0.702-0.82）。以血清sCD147含量≥2.71μg·L-1为临界值,用血清sCD147含量诊断CAHD的敏感度为73.1%,特异度为76.9%。结论：血清sCD147含量与CAHD发病风险显著正相关,可作为CAHD发病监测及CAHD早期诊断的检测指标。

Association between Soluble CD147 Content in Serum and Coronary Atherosclerosis Heart Disease Risk： a Case-control Study

Objective： To quantitatively examine soluble CD147 content in serum of patients with coronary atherosclerosis heart disease（CAHD） and to evaluate its utility as a risk predictor for CAHD. Methods： Blood samples from 130 CAHD（including 50 patients with stable angina pectoris（SAP）, 46 with unstable angina pectoris（UAP）, 34 with acute myocardial infarction（AMI）） and 130 healthy controls were collected. Serum sCD147 content in each group was detected by enzyme-linked immunosorbent assay. The clinical association of serum sCD147 expression with CAHD was analyzed and receiver operating characteristic（ROC） curve was performed to predict the risk of CAHD by sCD147 content in serum. Results： The authors found that CAHD patients exhibited statistically significantly higher sCD147 content（median： AMI, 3.35 μg·L-1; UAP, 2.72 μg·L-1; SAP, 2.66 μg·L-1） than matched controls（median： 1.64 μg·L-1; P〈0.001）. Serum sCD147 content was found to be positively associated with TG（P = 0.021）, LDL-C（P = 0.035） and AIP（P = 0.039）. Compared with individuals who had lower sCD147 content, individuals who had higher sCD147 content had a significantly increased risk of CAHD（adjusted OR, 2.18; 95% CI, 1.49-2.96） when healthy controls were used as the reference group. A significant dose-response relation was observed between CAHD risk and higher sCD147 content（P for trend 0.001）. In addition, the area under the ROC curve performed by the serum sCD147 from all participants was 0.761（95% CI： 0.702-0.82）. With a cutoff value of 2.71 μg· L-1, the overall sensitivity was 73.1% and specificity was 76.9%. Conclusion： Serum sCD147 content is positively related with the risk of CAHD. It could be used in monitoring the occurrence of CAHD and may be a potential marker for early diagnosis of CAHD.