2023 年第 3 期 第 18 卷

非ST段抬高型急性冠状动脉综合征患者中外周血透明质酸酶2和CD44异构体6的表达及其与斑块不稳定性的关系

Expressions of peripheral blood hyaluronidase 2 and CD44 isomer 6 in patients with non-ST-segment elevation acute coronary syndrome and their relationship with plaque instability

作者：李娟1王建成1张艳华1王刚2

英文作者：Li Juan1 Wang Jiancheng1 Zhang Yanhua1 Wang Gang2

单位：1首都医科大学附属北京友谊医院检验科，北京100050；2首都医科大学附属北京友谊医院心内科，北京100050

英文单位：1Department of Laboratory Medicine Beijing Friendship Hospital Capital Medical University Beijing 100050 China; 2Department of Cardiology Beijing Friendship Hospital Capital Medical University Beijing 100050 China

关键词：非ST段抬高型急性冠状动脉综合征；透明质酸酶2；CD44异构体6；斑块稳定性

英文关键词：Non-ST-segmentelevationtypeacutecoronarysyndrome;Hyaluronidase2;CD44isomer6;Plaquestability

• 摘要：

• 目的 探讨非ST段抬高型急性冠状动脉综合征（NSTE-ACS）患者中外周血透明质酸酶2和CD44异构体6(CD44v6)的表达及其与斑块不稳定性的关系。方法 选取2019年3月至2021年9月在首都医科大学附属北京友谊医院诊治的62例NSTE-ACS患者作为NSTE-ACS组，48例稳定型心绞痛（SAP）患者作为SAP组。采用荧光定量聚合酶链反应法检测2组外周血透明质酸酶2、CD44v6表达水平。Pearson相关分析方法分析外周血透明质酸酶2、CD44v6水平与血管内超声指标的相关性。多因素Logistic回归分析NSTE-ACS发生的危险因素。受试者工作特征（ROC）曲线分析透明质酸酶2、CD44v6单独及联合检测对NSTE-ACS的诊断价值。结果 NSTE-ACS组外周血透明质酸酶2、CD44v6相对表达量均高于SAP组［（9.2±2.3）比（3.3±0.5）、（16.9±3.6）比（7.3±1.3）］（均P＜0.001）。NSTE-ACS组外周血透明质酸酶2、CD44v6表达与最小管腔外弹力膜面积、斑块负荷、斑块坏死核心面积比呈正相关（均P＜0.05）。多因素Logistic回归分析结果显示，高密度脂蛋白胆固醇降低、透明质酸酶2升高及CD44v6升高是NSTE-ACS发生的独立危险因素（均P＜0.05）。ROC曲线分析结果表明，外周血透明质酸酶2、CD44v6单独及联合检测对NSTE-ACS诊断的曲线下面积分别为0.696、0.757、0.820，透明质酸酶2、CD44v6联合检测的曲线下面积明显大于单一指标检测(Z=4.661，P＜0.001；Z=3.885，P=0.001)。结论 NSTE-ACS患者外周血透明质酸酶2、CD44v6水平升高且与斑块稳定性有关，是NSTE-ACS发生的独立危险因素，二者联合检测对NSTE-ACS的诊断有一定的临床价值。

• Objective  To investigate the expressions of peripheral blood hyaluronidase 2 and CD44 isomer 6 in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and their relationship with plaque instability. Methods  From March 2019 to September 2021, 62 patients with NSTE-ACS diagnosed and treated in Beijing Friendship Hospital, Capital Medical University were selected as NSTE-ACS group, and 48 patients with stable angina pectoris (SAP) were selected as SAP group. The expression levels of peripheral blood hyaluronidase 2 and CD44 isomer 6 of the two groups were detected by fluorescence quantitative polymerase chain reaction method. Pearson correlation analysis method was used to analyze the correlation between the levels of peripheral blood hyaluronidase 2 and CD44 isomer 6 and intravascular ultrasound indicators. Multivariate Logistic regression analysis was used to analyze the risk factors of NSTE-ACS. The diagnostic values of hyaluronidase 2 and CD44 isomer 6 in single and combined detection of NSTE-ACS were analyzed by receiver operating characteristic (ROC) curve. Results  The relative expressions of peripheral blood hyaluronidase 2 and CD44 isomer 6 in NSTE-ACS group were higher than those in SAP group ［(9.2±2.3) vs (3.3±0.5), (16.9±3.6) vs (7.3±1.3)］ (both P＜0.001). The expressions of peripheral blood hyaluronidase 2 and CD44 isomer 6 in NSTE-ACS group were positively correlated with the minimum extraluminal elastic membrane area, plaque load and the ratio of plaque necrosis core area (all P＜0.05). Multivariate Logistic regression analysis showed that the reduction of high-density lipoprotein cholesterol, and the increase of hyaluronidase 2 and CD44 isomer 6 were independent risk factors for NSTE-ACS (all P＜0.05). The Results   of ROC curve analysis showed that the areas under the curve of diagnostic value of hyaluronidase 2 and CD44 isomer 6 in single and combined detection of NSTE-ACS were 0.696, 0.757 and 0.820, respectively. The area under the curve of hyaluronidase 2 and CD44 isomer 6 in the combined detection was significantly larger than that of single indicator detection (Z=4.661, P＜0.001; Z=3.885, P=0.001). Conclusion  The levels of peripheral blood hyaluronidase 2 and CD44 isomer 6 increase and are related to plaque stability in patients with NSTE-ACS, being independent risk factors for the occurrence of NSTE-ACS. The combined detection of the two has a high diagnostic value for NSTE-ACS.