急性冠脉综合征患者消退素D2及G蛋白偶联受体18水平与预后的关系_第二期_2026_医学理论研究

1.安徽医科大学第三附属医院（合肥市第一人民医院）心血管内科，安徽合肥 230000 2.安徽医科大学第三附属医院 (合肥市第一人民医院) 急诊科，安徽合肥 230000

摘要：目的探讨急性冠脉综合征（ACS）患者血清消退素D2（RvD2）及其受体G蛋白偶联受体18（GPR18）水平的变化，并分析二者对患者短期预后的预测价值。方法选取156例ACS患者，根据临床表现及辅助检查分为不稳定型心绞痛（UA）组和急性心肌梗死（AMI）组；并依据冠状动脉造影结果将AMI组患者分为单支病变组与多支病变组，并计算SYNTAX及Gensini评分。所有AMI患者均接受为期6个月的随访，并根据主要不良心血管事件（MACE）的发生情况，将其归类为预后不良组或预后良好组；另选同期95例健康体检者作为对照组。采用ELISA法检测血清RvD2和GPR18水平，分析其与ACS临床分型、冠脉病变程度、Gensini评分及MACE发生率之间的关系，评估二者在ACS病情严重程度和预后判断中的潜在价值。结果 ①与对照组相比，UA组和AMI组患者血清RvD2及GPR18水平均显著降低（均P＜0.05），且AMI组低于UA组（P＜0.05）。②单支与多支病变组血清RvD2和GPR18水平均低于对照组（均P＜0.05），但两组间差异无统计学意义（P＞0.05）。③Spearman相关分析显示，ACS患者血清RvD2与GPR18水平呈正相关（P＜0.001）；在AMI患者中，两者均与SYNTAX评分和Gensini评分呈负相关（均P＜0.001）。④多因素逐步Logistic回归分析提示，血清RvD2和GPR18水平是ACS发生的独立保护因素。⑤绘制ROC曲线分析显示, RvD2联合GPR18对ACS后发生不良事件具有一定预测效能。结论血清RvD2联合GPR18 水平能较为有效地评估ACS患者病情严重程度并预测短期预后，是ACS的保护因素。

关键词：急性冠脉综合征；消退素D2；G蛋白偶联受体18；临床预后

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