目的 探讨急性心肌梗死（AMI）患者血清血管生成素样蛋白8（ANGPTL8）、Kruppel样因子2（KLF2）表达与冠脉病变程度及主要心脏不良事件（MACE）发生的关系。 方法 选取106例AMI患者为研究对象，根据冠脉病变程度将患者分为轻度组（52例）和重度组（54例），根据MACE发生情况将患者分为MACE组（18例）和非MACE组（88例）。收集患者一般资料，酶联免疫吸附试验（ELISA）法检测血清ANGPTL8、KLF2水平，Spearman相关分析AMI患者血清ANGPTL8、KLF2水平与Gensini评分的相关性，多因素Logistic回归分析AMI患者冠脉病变程度的影响因素；绘制受试者工作特征（ROC）曲线分析血清ANGPTL8、KLF2水平预测AMI患者发生MACE的价值。 结果 重度组AMI患者高血压史、高血脂史患者比例，收缩压、舒张压、三酰甘油（TG）、N-末端B型利钠肽原（NT-proBNP）、心肌肌钙蛋白I（cTnI）水平，Gensini评分以及血清ANGPTL8水平高于轻度组（P < 0.05），高密度脂蛋白胆固醇（HDL-C）水平以及血清KLF2水平低于轻度组（P < 0.05）；且轻度组和重度组AMI患者病变支数比较，差异有统计学意义（P < 0.05）。AMI患者血清ANGPTL8水平与Gensini评分呈正相关（r = 0.638，P < 0.05），血清KLF2水平与Gensini评分呈负相关（r = -0.612，P < 0.05）。高血压史、高血脂史、cTnI、ANGPTL8是AMI患者冠脉病变进展为重度的危险因素（P < 0.05），而HDL-C、KLF2是保护因素（P < 0.05）。MACE组血清ANGPTL8水平高于非MACE组（P < 0.05），而血清KLF2水平低于非MACE组（P < 0.05）。血清ANGPTL8、KLF2水平及二者联合预测AMI患者发生MACE的曲线下面积分别为0.740（95%CI：0.646 ~ 0.820）、0.799（95%CI：0.710 ~ 0.870）、0.806（95%CI：0.717 ~ 0.876）。 结论 血清ANGPTL8、KLF2表达均与AMI患者冠脉病变程度密切相关，且对MACE发生具有一定预测价值。

Objective To investigate the relationship between the expression of serum angiopoietin?like protein 8 （ANGPTL8） and Kruppel?like factor 2 （KLF2） and the degree of coronary artery disease and the occurrence of major adverse cardiac events （MACE） in patients with acute myocardial infarction （AMI）. Methods A total of 106 patients with AMI who were hospitalized in our hospital from January 2021 to June 2023 were selected as the research objects. According to the degree of coronary artery disease， the patients were grouped into mild group （52 cases） and severe group （54 cases）. According to the occurrence of MACE， the patients were grouped into MACE group （18 cases） and non?MACE group （88 cases）. General patient data were collected. Serum ANGPTL8 and KLF2 levels were detected by enzyme?linked immunosorbent assay （ELISA）. Spearman correlation analysis was applied to analyze the correlation between serum ANGPTL8 and KLF2 levels and Gensini score in AMI patients. Multivariate logistic regression was applied to analyze the influencing factors of coronary artery disease degree in patients with AMI. Receiver operating characteristic （ROC） curves were drawn to analyze the value of serum ANGPTL8 and KLF2 levels in predicting the occurrence of MACE in AMI patients. Results The proportions of patients with history of hypertension and hyperlipidemia， systolic blood pressure， diastolic blood pressure， levels of triacylglycerol （TG）， N?terminal pro?B?type natriuretic peptide （NT?proBNP）， cardiac troponin I （cTnI）， Gensini score， and level of serum ANGPTL8 in the severe group were higher than those in the mild group （P < 0.05）. The level of high?density lipoprotein cholesterol （HDL?C） and serum KLF2 in the severe group were lower than those in the mild group （P < 0.05）. The number of lesions in the mild group and the severe group was statistically obvious （P < 0.05）. Serum ANGPTL8 level in AMI patients was positively correlated with Gensini score （r = 0.638， P < 0.05）， and serum KLF2 level was negatively correlated with Gensini score （r = -0.612， P < 0.05）. History of hypertension， hyperlipidemia， cTnI and ANGPTL8 were risk factors for the progression of severe coronary artery disease in patients with AMI （P < 0.05）， while HDL?C and KLF2 were protective factors （P < 0.05）. The serum level of ANGPTL8 in AMI patients in the MACE group was higher than that in the non?MACE group （P < 0.05）， and the serum KLF2 level in the MACE group was lower than that in the non?MACE group （P < 0.05）. The area under the curve of serum ANGPTL8 and KLF2 levels and their combination in predicting the occurrence of MACE in AMI patients was 0.740 （95%CI： 0.646 ~ 0.820）， 0.799 （95%CI： 0.710 ~ 0.870）， and 0.806 （95%CI： 0.717 ~ 0.876）， respectively. Conclusion The expressions of serum ANGPTL8 and KLF2 are closely related to the degree of coronary artery disease in patients with AMI， and have certain predictive value for the occurrence of MACE.