| Objective:The purpose of this study was to explore the diagnostic value of these three indexes and its correlation with the severity of coronary le-sions in acute coronary syndrome（ACS）by detecting the serum soluble growth stimulator gene 2 protein（serum sST2）,hypersensitive C-reactive protein（HsCRP）and Neutrophil to lymphocyte ratio（NLR）,and the aim was to find simple and efficient indicators to evaluate condition of ACS.Methods:A total of 173 patients with coronary heart disease hospitalized in the second Department of Cardiology,the Affiliated Hospital of Beihua University from October 2018 to November 2019 were divided into sta-ble angina pectoris（SA）group（n=63）and acute coronary syndrome（ACS）group（n=110）.The patients in ACS group were divided into acute myocardial infarction（AMI）group（n=54）and unstable angina pectoris（UA）group（n=56）according to their pathological condition.According to the number of diseased coronary arteries,the ACS group was divided into three groups:single-vessel disease group（n=13）,two-vessel disease group（n=28）and multi-vessel disease group（n=69）.The severity of coronary lesions was scored by Gensini integration.The concentration of sST2（Human ST2/IL-33R kit,made by American R&D Company）,HsCRP and blood routine test（calculating the ratio of neutrophil to lym-phocyte,NLR）were detected in all patients.The levels of the three indi-cators were expressed by mean±standard deviation or Md（IQR）.And t-test,rank sum test and analysis of variance were used for comparison among the different groups.In ACS group,the correlation between sST2and the other two indicators（HsCRP and NLR）,the three indicators（sST2,HsCRP and NLR）and Gensini score were analyzed by Pearson or Spearman correlation analysis.The diagnostic value of sST2,HsCRP and NLR in patients with ACS was evaluated by Logistic regression analysis and ROC curve.The correlation were analyzed in these three in-dexes（sST2,HsCRP and NLR）and Gensini score by multiple linear stepwise regression.Results:1.Comparing the basic clinical datas of ACS group and SA group,there were significant differences in smoking history and HDL（P<0.05）,and there was no significant difference in other groups（P>0.05）.2.The concentration of serum sST2 and HsCRP in ACS group and SA group were 20.26±9.36 ng/ml and 13.90±5.97 ng/ml,3.57（1.91-6.88）mg/L and 1.50（0.50-4.07）mg/L,NLR being 4.10（2.49-6.42）and 2.3（1.62-3.19）,respectively.The levels of three factors in ACS group were significantly higher than those in SA group（P<0.05）.3.The levels of serum sST2,HsCRP and NLR in AMI group were significantly higher than those in UA group（P<0.05）.The concentration of sST2 were 23.68±9.49ng/ml and 16.97±8.02 ng/ml.HsCRP were3.57（1.91-6.88）mg/L and 1.50（0.50-4.07）mg/L,while NLR being 4.10（2.49-6.42）and 2.3（1.62-3.19）,respectively.4.There was a positive correlation between serum sST2 and the oth-er two indicators（HsCRP and NLR）in patients with ACS（r=0.248 and0.321,P<0.05）.5.The results of binary Logistic regression analysis showed that the influence of smoking history and HDL-C in the diagnosis of ACS was excluded（P>0.05）,serum sST2 and NLR were the influencing factors for the diagnosis of ACS（P<0.05）,while HsCRP was not the influencing factor for the diagnosis of ACS（P>0.05）.The results of ROC curve analysis showed that the area under the ROC curve（AUC）of serum sST2was 0.707,the optimal critical value was 18.29 ng/ml,the sensitivity was 53.21%,and the specificity was 79.40%（P<0.05）.The AUC of NLR was 0.667,the optimal critical value was 2.87,the sensitivity was 50.46%,and the specificity was 81.00%.When sST2 and NLR were detected to-gether,the AUC was 0.744,and the sensitivity and specificity were 55.96%and 88.90%,respectively（P<0.05）.6.The levels of the three indicators（sST2,HsCRP and NLR）were no significant difference in the different number of diseased coronary ar-teries of the patients with ACS（P>0.05）.7.sST2,HsCRP and NLR in patients with ACS were positively cor-related with Gensini score（r=0.519,0.363,0.313,respectively,P<0.05）.8.The results of multiple stepwise regression analysis showed that the fitting regression equation was as follows:YGensini=21.245+2.158XsST2+3.696XNLR（F=25.158,P<0.05）,the standardization coefficient of sST2 and NLR were 0.450 and 0.234,respectively.Serum sST2 and NLR had certain significance in indicating the severity of cor-onary lesions in patients with ACS,and the hint value of sST2 was great-er than that of NLR.Conclusion:1.The expression of sST2,HsCRP and NLR were related to the se-verity of ACS,and might be related to the degree of inflammation of coronary artery vulnerable plaques.The combined detection of sST2 and NLR could be used as auxiliary indexes for the diagnosis and differential diagnosis of acute coronary syndrome.2.sST2,HsCRP and NLR were related to the severity of coronary lesions of ACS（Gensini score）.Among them,both sST2 and NLR had certain hint value for the degree of coronary artery disease in ACS,but the hint value of sST2 was greater. |
