摘要目的 探讨血清卵泡抑素样蛋白-1(FSTL1)在急性冠状动脉综合征(ACS)患者经皮冠状动脉成形术( PCI)治疗效果评价及预后判断中的作用.方法 选取2015 年1 月至2016 年12月连云港市第二人民医院心血管内科收治的100 例ACS患者,其中不稳定型心绞痛( UAP)者26例、非ST段抬高型心肌梗死(NSTEMI)者45例、ST段抬高型心肌梗死( STEMI)者29例,按照不同治疗方式分为PCI治疗组与药物治疗组,每组50例. PCI治疗组患者于明确诊断后12 h内完成PCI治疗,同时给予双联抗血小板、抗凝、血管活性药物、扩张冠状动脉、营养心肌、降血脂等药物综合治疗.药物治疗组患者给予双联抗血小板、抗凝、血管活性药物、扩张冠状动脉、营养心肌、降血脂等药物综合治疗.两组患者在治疗前、治疗后24 h及7 d分别采用酶联免疫吸附法测定血清FSTL1水平.所有患者均随访6个月,观察主要心脏不良事件( MACE)的发生情况.结果 PCI治疗组患者治疗后24 h、7 d血清FSTL1水平较治疗前显著下降,差异有统计学意义(P<0. 05).药物治疗组患者治疗后7 d血清FSTL1水平[(8.35 ±3.26)ng/ml]较治疗前[(12.05 ±1.83)ng/ml]显著下降,差异有统计学意义( P <0. 05). PCI 治疗组患者治疗后 24 h 及 7 d 血清 FSTL1 水平[(7. 05 ±3. 58)ng/ml、(4. 68 ±1. 63)ng/ml]较药物治疗组[(12. 67 ±0. 52)ng/ml、(8. 35 ±3. 26)ng/ml]均显著下降,差异有统计学意义(P<0. 05).所有患者随访6月,共有8例患者发生MACE,其中PCI治疗组1例,药物治疗组7例,两组比较差异有统计学意义(P<0. 05).未发生MACE患者治疗前、治疗后24 h及治疗后7 dFSTL1水平[(12. 05 ± 2. 21)ng/ml、(9. 11 ± 1. 45)ng/ml、(4. 95 ± 2. 27)ng/ml]均显著低于发生 MACE 患者的同期水平[( 20. 11 ± 4.15 ) ng/ml、 ( 15. 52 ± 3. 65 ) ng/ml、(9. 92 ± 2. 13)ng/ml],差异有统计学意义(P<0. 05).结论 ACS患者PCI治疗后血清FSTL1水平显著下降,且可降低MACE的发生率,ACS患者血清FSTL1水平检测对于评价治疗效果、判断预后具有一定的临床意义.

abstractsObjective To investigate the value of follistatin-like 1(FSTL1)in acute coronary syn-drome patients treated with percutaneous coronary intervention ( PCI). Methods 100 patients with ACS were included in department of Cardiovascular medicine,Lianyugang Second People′s Hospital from January 2015 to December 2016. 26 patients were unstable angina pectoris,45 patients were non-ST-segment eleva-tion myocardial infarction,29 patients were ST segment elevation myocardial infarction. All patients were di-vided into PCI group(n＝50)and drug group(n＝50)according to the therapeutic method. Patients in PCI group were performed PCI in 12 h after diagnosing denfinitively,and were adiministrated drug thepapy of dual antiplatelet,anticoagulation,vasoactive drugs,anti-tensor coronary artery,nutrition myocardial and anti- hyperlipidemia. Patients in drug group were adiministrated drug thepapy of dual antiplatelet, anticoagula-tion,vasoactive drugs, anti-tensor coronary artery, nutrition myocardial and anti-hyperlipidemia. Enzyme linked immunosorbent assay measured the level of FSTL1 at prior treatment,24 h after treatment,7 d after treatment. All patients were followed up for 6 months,and the incidence of major adverse cardiac events (MACE)was observed. Results The serum levels of FSTL1 in PCI group at 24 h,7d after treatment were significantly lower than those before treatment(P<0. 05). The level of serum FSTL1 in the drug group at 7 d[(8. 35 ± 3. 26)ng/ml]after treatment was significantly lower than those before treatment[(12. 05 ± 1. 83)ng/ml](P<0. 05). The serum levels of FSTL1 in PCI group at 24 h[(7. 05 ± 3. 58)ng/ml]and 7 d [(4.68±1.63)ng/ml]after treatment were lower than those in drug group[(12.67 ±0.52)ng/ml、(8. 35 ±3. 26)ng/ml](P<0. 05). Followed up for 6 months,one patient occured MACE in PCI group, seven patients occured MACE in drug group(P<0. 05). The FSTL1 of no MACE patients at pre-treatment [(12. 05 ± 2. 21)ng/ml],24 h[(9. 11 ± 1. 45)ng/ml]and 7 d[(4. 95 ± 2. 27)ng/ml]after treatment were lower than those of MACE patients[(20. 11 ±4. 15)ng/ml、(15. 52 ±3. 65)ng/ml、(9. 92 ±2. 13)ng/ml] (P<0. 05). Conclusion The level of FSTL1 in ACS patients and the incidence of MACE both decreases significantly. The examination of serum FSTL1 level in ACS patients has clinical value for evaluating the therapeutic effect and prognosis.