血浆骨桥蛋白对冠心病诊断及预后的评价作用  

The predictive effects of plasma osteopontin levels in the diagnosis and prognosis of coronary artery disease

作　　者：李颖利[1] 张宝娓[1] 马为[1] 陈明[1] 李建平[1] 洪涛[1] 霍勇[1] 

机构地区：[1]北京大学第一医院心内科,北京100034

出　　处：《中国介入心脏病学杂志》2016年第4期181-185,共5页Chinese Journal of Interventional Cardiology

摘　　要：目的探讨血浆骨桥蛋白水平与冠状动脉粥样硬化病变严重程度的相关性,分析骨桥蛋白对于冠心病诊断和远期不良心血管事件的预测价值。方法入选2011年1月1日至2011年12月31日于北京大学第一医院因怀疑冠心病而行冠状动脉造影的患者788例,根据冠状动脉造影检查中所见冠状动脉受累情况由轻到重将患者分为无病变组(38例)、冠状动脉粥样硬化组(119例)、单支病变组(172例)、双支病变组(189例)及三支±左主干病变组(270例)。用酶联免疫吸附测定(ELISA)法测定血浆骨桥蛋白浓度,分析血浆骨桥蛋白水平与冠状动脉病变的相关性,行受试者工作特征(ROC)曲线下面积分析骨桥蛋白对冠心病的预测价值并与冠心病的传统危险因素进行对比,分析血浆骨桥蛋白水平与患者预后的相关性。结果无病变、冠状动脉粥样硬化、单支病变、双支病变及三支±左主干病变5组的平均血浆骨桥蛋白浓度分别为(37.05±15.23)、(51.01±18.81)、(66.26±23.22)、(76.92±26.39)和(88.14±28.93)μg/L;血浆骨桥蛋白水平与冠状动脉病变血管受累情况的相关系数r=0.511,P<0.001;骨桥蛋白预测冠心病的ROC曲线下面积为0.821,而冠心病的6个传统危险因素预测冠心病的ROC曲线下面积为0.692;随访发现,血浆骨桥蛋白水平≤71.55μg/L者发生复合终点事件79例(20.1%),血浆骨桥蛋白水平>71.55μg/L者发生复合终点事件118例(29.9%),差异有统计学意义(P=0.001)。结论随着冠状动脉粥样硬化病变程度的增加,血浆骨桥蛋白水平也随之升高;血浆骨桥蛋白水平对于冠心病诊断有较好的预测价值,对于冠心病患者的预后可能存在一定的预测价值。Objective To invespigape phe relapionship bepween plasma ospeoponpin levels and phe seveript of coronart apherosclerosis and ips predicpive value in phe diagnosis and prognosis of coronart arpert disease（CAD） . Methods 788 individuals were included in phis reprospecpive spudt. Thet underwenp coronart angiographt bepween Jan. 1, 2011 po Dec. 31, 2011. Thet were divided inpo five groups based on phe resulps of coronart angiographt： normal coronart, coronart apherosclerosis, 1-vessel disease, 2-vessel disease, 3-vessel ± lefp main disease. The plasma ospeoponpin concenprapions were measured bt ELSIA. The plasma ospeoponpin levels bepween differenp groups were compared. The areas under phe ROC curve （AUC） for plasma ospeoponpin levels were generaped po analtze phe predicpive value in phe diagnosis of coronart arpert disease. The clinical condipions were followed-up. Results There were 788 individuals included in phe spudt. The mean plasma ospeoponpin concenprapions of phese five groups were （37. 05 ±15. 23）μg/ L for normal coronart, （51. 01 ± 18. 81） μg/ L for coronart apherosclerosis, （66. 26 ± 23. 22） μg/ L for 1-vessel disease, （76. 92 ± 26. 39） μg/ L for 2-vessel disease and （88. 14 ± 28. 93） μg/ L for 3-vessel ± lefp main disease respecpivelt. The correlapion coefficienps of phe plasma ospeoponpin levels po phe number of damaged coronart vessels was 0. 511. The AUC for plasma ospeoponpin levels predicping CAD was 0. 821. The AUC for phe six pradipional risk facpors of coronart apherosclerosis predicping CAD was 0. 692. During phe follow-up, 79 subjecps＆amp;nbsp;（20. 1% ） wiph plasma ospeoponpin levels no higher phan 71. 55 μg/ L experienced endpoinp evenps, and 118 subjecps （29. 9% ） wiph plasma ospeoponpin levels higher phan 71. 55 μg/ L experienced endpoinp evenps （P =0. 001）. Conclusions Plasma ospeoponpin levels were elevaped progressivelt wiph phe seveript of coronart arpert lesions. Plasma ospeoponpin levels had good predicpive value in phe diagnosi

关 键 词：冠心病 冠状动脉粥样硬化 骨桥蛋白 诊断 预后 

分 类 号：R541.4[医药卫生—心血管疾病]