2026 年第 2 期 第 21 卷

血清长链非编码RNA PSMB8-AS1和肌肉因子53水平与急性冠状动脉综合征患者冠状动脉病变程度以及预后的关系分析

Correlation analysis of serum long non-coding RNA PSMB8-AS1 and myokine 53 levels with coronary lesion severity and prognosis in patients with acute coronary syndrome

作者：郭泰武1牛明远2张艳君2汉辉3索朗片多1张晓彬4

英文作者：Guo Taiwu1 Niu Mingyuan2 Zhang Yanjun2 Han Hui3 Suolangpianduo1 Zhang Xiaobin4

单位：1西藏自治区日喀则市人民医院急诊科，日喀则857012；2西藏自治区日喀则市人民医院心内科，日喀则857012；3上海交通大学医学院附属瑞金医院心内科，上海200025；4上海交通大学医学院附属仁济医院急诊内科，上海200025

英文单位：1Department of Emergency People′s Hospital of Shigatse City Tibet Autonomous Region Shigatse 857012 China; 2Department of Cardiology People′s Hospital of Shigatse City Tibet Autonomous Region Shigatse 857012 China; 3Department of Cardiology Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai 200025 China; 4Department of Emergency Internal Medicine Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai 200025 China

关键词：急性冠状动脉综合征；冠状动脉病变程度；预后；长链非编码RNAPSMB8-AS1；肌肉因子53

英文关键词：Acutecoronarysyndrome；Coronarylesionseverity；Prognosis；Longnon-codingRNAPSMB8-AS1；Myokine53

• 摘要：

• 目的 探讨血清长链非编码RNA PSMB8-AS1和肌肉因子53（MG53）水平与急性冠状动脉综合征（ACS）患者冠状动脉病变程度以及预后的关系。方法 采用前瞻性队列研究设计，选取2021年4月至2023年4月西藏自治区日喀则市人民医院、上海交通大学医学院附属仁济医院收治的352例ACS患者（ACS组）和同期西藏自治区日喀则市人民医院100例健康体检志愿者（对照组），根据冠状动脉造影Gensini 评分将ACS患者分为轻度组（Gensini评分≤40分，120例）、中度组（Gensini评分41～79分，162例）和重度组（Gensini评分≥80分，70例）。随访1年内不良心血管事件发生情况。所有受试者均于入组24 h内检测血清lncRNA PSMB8-AS1表达和MG53水平，多因素Logistic回归分析ACS患者预后的影响因素，受试者工作特征曲线分析lncRNA PSMB8-AS1和MG53预测ACS患者预后的价值。结果 ACS组血清lncRNA PSMB8-AS1表达和MG53水平均高于对照组［（2.96±0.71）比（1.36±0.33）、（456±96）ng/L比（108±20）ng/L］（均P＜0.05）。重度组血清lncRNA PSMB8-AS1表达和MG53水平均高于中度组和轻度组（均P＜0.05）。随访1年内2例失访，63例发生不良心血管事件，预后不良组血清lncRNA PSMB8-AS1表达和MG53水平均高于预后良好组（均P＜0.05）。高N末端B型脑钠肽前体（NT-proBNP）、高表达lncRNA PSMB8-AS1、高水平MG53是ACS患者预后不良的危险因素（均P＜0.05），高左心室射血分数（LVEF）是保护因素（P＜0.05）。lncRNA PSMB8-AS1和MG53预测ACS患者预后的曲线下面积（AUC）分别为0.806、0.862，高于LVEF（均P＜0.05），与NT-proBNP差异无统计学意义（P＞0.05）。联合lncRNA PSMB8-AS1和MG53预测ACS患者预后的AUC为0.953，高于二者单独预测（均P＜0.05）。结论 ACS患者血清lncRNA PSMB8-AS1表达和MG53水平增高与冠状动脉病变较重以及不良预后有关，联合检测lncRNA PSMB8-AS1、MG53有助于预测ACS患者不良预后风险。

• Objective To investigate the correlation of serum long non-coding RNA (lncRNA) PSMB8-AS1 and myokine 53 (MG53) levels with coronary lesion severity and prognosis in patients with acute coronary syndrome (ACS). Methods A prospective cohort study was conducted, enrolling 352 ACS patients admitted to People′s Hospital of Shigatse City, Tibet Autonomous Region and Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2021 to April 2023 (ACS group) and 100 healthy volunteers who underwent physical examination during the same period (control group) in People′s Hospital of Shigatse City, Tiet Autonomous Region. According to the Gensini score of coronary angiography, ACS patients were divided into mild group (Gensini score ≤ 40, 120 cases), moderate group (Gensini score 41-79, 162 cases) and severe group (Gensini score ≥ 80, 70 cases). The occurrence of major adverse cardiovascular events (MACEs) was followed up for 1 year. Serum lncRNA PSMB8-AS1 expression and MG53 levels were detected in all subjects within 24 h of enrollment. Multivariate Logistic regression was used to analyze the influencing factors of prognosis in ACS patients. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of lncRNA PSMB8-AS1 and MG53 for prognosis in ACS patients. Results The serum lncRNA PSMB8-AS1 expression and MG53 levels in the ACS group were significantly higher than those in the control group ［(2.96±0.71) vs (1.36±0.33), (456±96)ng/L vs (108±20)ng/L］(both P＜0.05). The serum lncRNA PSMB8-AS1 expression and MG53 levels in the severe group were significantly higher than those in the moderate and mild groups (all P＜0.05). During the 1-year follow-up, 2 patients were lost to follow-up and 63 patients developed MACEs. The serum lncRNA PSMB8-AS1 expression and MG53 levels in the poor prognosis group were significantly higher than those in the good prognosis group (all P＜0.05). High N-terminal pro-brain natriuretic peptide (NT-proBNP), high lncRNA PSMB8-AS1 expression and high MG53 level were risk factors for poor prognosis in ACS patients (all P＜0.05), while high left ventricular ejection fraction (LVEF) was a protective factor (P＜0.05). The areas under the curve (AUC) of lncRNA PSMB8-AS1 and MG53 for predicting prognosis in ACS patients were 0.806 and 0.862, respectively, which were higher than that of LVEF (both P＜0.05), and showed no significant difference compared with that of NT-proBNP (P＞0.05). The AUC of combined detection of lncRNA PSMB8-AS1 and MG53 for predicting prognosis in ACS patients was 0.953, which was higher than that of each single index (both P＜0.05). Conclusion The increased serum lncRNA PSMB8-AS1 expression and MG53 levels in ACS patients are associated with severe coronary lesions and poor prognosis. Combined detection of lncRNA PSMB8-AS1 and MG53 is helpful for predicting the risk of poor prognosis in ACS patients.