CTO患者血浆ESM-1水平与冠脉侧支循环形成的相关性研究  

Study on the correlation between plasma ESM-1 level and formation of coronary collateral circulation in patients with chronic coronary occlusion

作　　者：王佳佳[1] 郭荣[1] 何飞[1] Wang Jiajia;Guo Rong;He Fei(Department of Cardiovascular,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院心血管内科,河南郑州450000

出　　处：《河南医学研究》2018年第11期1931-1935,共5页Henan Medical Research

基　　金：国家自然科学基金资助项目(81070445);河南省医学科技攻关计划(201403030和201403029);河南省教育厅高等学校重点科研项目计划(18A320050)

摘　　要：目的探讨冠状动脉慢性闭塞(CTO)患者血浆内皮特异性分子1(ESM-1)水平与冠脉侧支循环形成之间的关系。方法选择郑州大学第一附属医院收治的68例CTO患者作为试验组,根据冠脉侧支循环形成情况分为侧支循环较差组(35例)和侧支循环较好组(33例);以同期住院接受CAG检查显示冠脉血管正常或接近正常(狭窄程度<30%)的39例患者作为对照组。收集患者基本临床数据,采用ELISA法测定血浆ESM-1和血管内皮细胞生长因子(VEGF)水平,分析ESM-1评估侧支循环形成的特异度和敏感度。结果与对照组相比,侧支循环较好组ESM-1及VEGF水平升高[(3.22±1.44)ng/ml比(1.53±0.68)ng/ml,P<0.01;(126.68±45.64)pg/ml比(76.24±37.45)pg/ml,P<0.01],且血浆ESM-1和VEGF水平与冠脉侧支循环形成呈正相关(r=0.389,P<0.001)。Logistic回归分析显示,ESM-1、VEGF、中性粒细胞、饮酒史是冠脉侧支循环形成的独立危险因素。ROC曲线分析显示,1.92 ng/ml ESM-1水平对冠脉侧支循环是否良好预测敏感性为69.7%,特异性为68.6%。结论 ESM-1水平与冠状动脉慢性闭塞患者冠脉侧支循环形成密切相关,是冠脉侧支循环形成的独立预测因子。Objective To investigate the relationship between plasma ESM-1 level and coronary collateral circulation in patients with coronary artery occlusion（ CTO）. Methods The 68 patients with CTO admitted to the First Affiliated Hospital of Zhengzhou University were selected as the experimental group. According to the formation of collateral circulation,the patients were divided into poor collateral circulation（ 35 cases） and better collateral circulation（ 33 cases）. In the same period of hospitalization,39 patients with normal or near normal coronary vascularity（ stenosis level 〈30%） were used as controls. The basic clinical data were collected and plasma ESM-1 and vascular endothelial growth factor（ VEGF） levels were measured by ELISA.The specificity and sensitivity of ESM-1 in the prediction of coronary collateral circulation formation were analyzed.Results Compared with the control group,the levels of ESM-1 and VEGF in the better collateral circulation group increased[（ 3. 22 ± 1. 44） ng/ml versus（ 1. 53 ± 0. 68） ng/ml,P〈0. 01;（ 126. 68 ± 45. 64） pg/ml versus（ 76. 24 ± 37. 45） pg/ml,P〈0. 01） ],and plasma ESM-1 and VEGF levels were positively correlated with coronary collateral circulation（ r = 0. 389,P 〈0. 001）. Logistic regression analysis showed that plasma ESM-1 level was an independent predictor of coronary collateral circulation. ROC curve analysis showed that ESM-1 was 69. 7% sensitive and 68. 6% specific for coronary collateral circulation at 1. 92 ng/ml. Conclusion ESM-1 level is closely related to the formation of coronary collateral circulation in patients with coronary artery occlusion. It is an independent predictor of coronary collateral circulation.

关 键 词：冠心病 冠状动脉慢性闭塞 内皮特异性分子1 侧支循环 

分 类 号：R541.4[医药卫生—心血管疾病]