血清补体C1q水平预测与区分急性冠脉综合征和稳定性冠心病的临床价值  

Clinical values of serum complement 1q levels in predicting and discriminating acute coronary syndrome and stable coronary artery disease

作　　者：季茳 吴嘉 王苏梦 李卓玲 汪俊军 

机构地区：[1]南京大学医学院附属金陵医院,解放军南京总医院临床检验科,南京210002

出　　处：《临床检验杂志》2018年第1期9-13,共5页Chinese Journal of Clinical Laboratory Science

基　　金：国家自然科学基金(81271904,81572074);国家重大科学仪器设备开发专项(2012YQ03026109);南京总医院院管课题(2015054)

摘　　要：目的探讨冠心病(CAD)患者血清补体1q(C1q)的水平,评估其对急性冠脉综合征(ACS)和稳定性冠心病(SCAD)的预测与区分价值。方法选取52例ACS患者、66例SCAD患者和54例健康人对照者纳入研究。采用免疫透射比浊法测定血清C1q、ELISA法测定血清氧化低密度脂蛋白(ox-LDL);同时分析血清总胆固醇、三酰甘油(TG)、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平;计算CAD患者Gensini积分;并通过逐步多元线性回归分析和Logistic回归分析探讨C1q对ACS和SCAD的预测与区分价值。结果与健康人对照组相比,ACS(C1q:t=4.405,P<0.001;ox-LDL:Z=5.941,P<0.001)和SCAD(C1q:t=2.320,P=0.022;ox-LDL:Z=4.119,P<0.001)组血清C1q、ox-LDL水平均显著升高;且ACS组血清C1q(t=2.344,P=0.021)、ox-LDL(Z=2.166,P=0.030)水平显著高于SCAD组。ACS组血清C1q水平与ox-LDL(r=0.246,P=0.028)、TG(r=0.232,P=0.002)及Gensini积分(r=0.341,P=0.020)呈显著正相关;逐步多元线性回归分析显示,在校正了年龄、性别及其他生化指标的影响后,ACS患者血清ox-LDL水平仍与C1q呈显著独立相关(β=0.676,P=0.045,校正R2=0.380)。多元Logistic回归分析显示,血清C1q、ox-LDL水平的升高均与ACS(C1q:OR=1.05,95%CI=1.03~1.08,P<0.001;ox-LDL:OR=1.18,95%CI=1.08~1.29,P<0.001)、SCAD(C1q:OR=1.04,95%CI=1.01~1.06,P=0.003;ox-LDL:OR=1.11,95%CI=1.03~1.18,P=0.004)的发生密切相关;且有助于区分ACS和SCAD发生(C1q:OR=1.01,95%CI=1.00~1.03,P=0.022;ox-LDL:OR=1.06,95%CI=1.01~1.12,P=0.023)。结论 CAD患者血清C1q水平升高;且ACS患者C1q水平高于SCAD患者。ACS患者血清C1q与ox-LDL水平显著独立相关。血清C1q水平可望作为预测与区分ACS和SCAD的新指标。Objective：To investigate serum complement 1q （C1q） levels in the patients with coronary artery disease （CAD）, and evaluate its clinical values in predicting and discriminating acute coronary syndrome （ACS） and stable coronary artery disease （SCAD）. Methods：A total of 52 ACS patients, 66 SCAD patients and 54 healthy controls were enrolled in this study. Their serum C1q and oxidized low-density lipoprotein （ox-LDL） levels were detected by an immune turbidimetric method and an enzyme linked immunosorbent assay, respectively. Their serum total cholesterol, triglyceride, high density lipoprotein cholesterol and low-density lipoprotein cholesterol levels were also determined. Then, the Gensini scores in CAD patients were calculated, and the clinical values of C1q in predicting and discriminating ACS and SCAD were evaluated by stepwise multiple linear regression analysis and Logistic regression analysis. Results：Serum C1q and ox-LDL levels in ACS （C1q：t=4.405, P〈0.001; ox-LDL： Z=5.941, P〈0.001） and SCAD （C1q： t=2.320, P=0.022; ox-LDL： Z=4.119, P〈0.001） patients were significantly higher than those in healthy controls. Moreover, serum C1q （t=2.344, P=0.021） and ox-LDL （Z=2.166, P=0.030） levels in ACS patients were significantly higher than that in SCAD patients. Serum C1q levels were positively correlated with serum ox-LDL （r=0.246, P=0.028） and TG （r=0.232, P=0.002） levels and Gensini scores （r=0.341, P=0.020） in ACS patients. The stepwise multiple regression analysis showed that serum ox-LDL levels were still independently correlated with serum C1q levels in ACS patients （β=0.676, P=0.045, adjusted R2=0.380） after adjusting for age, gender and other biochemical markers. The Logistic regression analysis showed that the increased serum C1q and ox-LDL levels were closely related to the occurrence of ACS （C1q： OR=1.05, 95%CI=1.03-1.08, P〈0.001; ox-LDL： OR=1.18, 95%CI=1.08-1.29, P〈0.001） and SCAD （C1q： OR=1.04, 95%CI=1.01-1.06, P=0.003;

关 键 词：C1Q 急性冠脉综合征 动脉粥样硬化 生物标志物 

分 类 号：R446.1[医药卫生—诊断学]