外周血可溶性弹性蛋白和弹性蛋白酶作为冠状动脉扩张的辅助诊断指标。

Peripheral blood soluble elastin and elastase as auxiliary diagnostic indicators for coronary artery ectasia.

机构信息

Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China

出版信息

Turk J Med Sci. 2021 Jun 28;51(3):1058-1064. doi: 10.3906/sag-1911-16.

DOI:10.3906/sag-1911-16

PMID:33315345

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8283459/

Abstract

BACKGROUND/AIM: Damage to elastin fibres in coronary media might lead to coronary artery ectasia (CAE). This study evaluated whether CAE can be distinguished by detecting circulating soluble elastin (s-elastin), which is a degradation product of elastin fibres, and elastase, which is the main enzyme of elastin fibres.

MATERIALS AND METHODS

Fifty-eight patients with CAE, 58 with coronary heart disease (CHD) and 61 with relatively normal coronary arteries, were included. Circulating s-elastin and elastase were measured, and receiver operating characteristic curves were used to demonstrate their respective optimal cut-off values for predicting CAE.

RESULTS

The concentrations of s-elastin and elastase were higher in the CAE group than in the CHD and relatively-normal-coronary groups. Their cut-off values for screening of CAE were 13.148 ng/mL and 25.549 ng/mL, respectively; for sensitivity of CAE were 0.690 and 0.773, respectively; and for specificity of CAE were 0.862 and 0.571, respectively. A combination of s-elastin and elastase in series (one of the two higher than its cut-off value) had a better sensitivity for screening for CAE, whereas their combination in parallel (both higher than their cut-off values) had a better specificity.

CONCLUSION

Circulating s-elastin and elastase are promising biomarkers for assisting in CAE diagnosis.

摘要

背景/目的：冠状动脉中层弹性纤维损伤可能导致冠状动脉扩张（CAE）。本研究评估了循环可溶性弹性蛋白（s-弹性蛋白）和弹性蛋白酶是否可以区分 CAE，s-弹性蛋白是弹性纤维的降解产物，弹性蛋白酶是弹性纤维的主要酶。

材料和方法

纳入 58 例 CAE 患者、58 例冠心病（CHD）患者和 61 例冠状动脉相对正常的患者。检测循环 s-弹性蛋白和弹性蛋白酶，并用受试者工作特征曲线（ROC 曲线）显示其各自预测 CAE 的最佳截断值。

结果

CAE 组的 s-弹性蛋白和弹性蛋白酶浓度高于 CHD 组和冠状动脉相对正常组。用于 CAE 筛查的截断值分别为 13.148ng/ml 和 25.549ng/ml；用于 CAE 筛查的敏感性分别为 0.690 和 0.773；用于 CAE 的特异性分别为 0.862 和 0.571。s-弹性蛋白和弹性蛋白酶串联（两者之一高于其截断值）联合检测对 CAE 的筛查具有更好的敏感性，而两者并联（两者均高于其截断值）联合检测对 CAE 的特异性更好。