血清补体C1q水平与老年患者冠状动脉狭窄程度的相关性研究  

Relationship between serum complement C1q and severity of coronary artery disease in the elderly

作　　者：匡圆圆 马琦琳[1] 张赛丹[1] KUANG Yuanyuan;MA Qilin;ZHANG Saidan(Department of Cardiology,Xiangya Hospital of Central South University,Changsha,Hunan,410008,China)

机构地区：[1]中南大学湘雅医院心内科,长沙410008

出　　处：《临床心血管病杂志》2018年第11期1077-1080,共4页Journal of Clinical Cardiology

基　　金：国家自然科学基金面上项目(No:81370250);湖南省科技厅课题(No:2017SK50108)

摘　　要：目的:探讨血清补体C1q水平与老年患者冠状动脉(冠脉)狭窄程度的相关性。方法:采用前瞻性研究,连续选取2017-12-01-2018-05-31首次于中南大学湘雅医院心内科住院且≥65岁的冠心病患者214例,入院后采用免疫透射比浊法测定其血清补体C1q水平,并完善冠脉造影,进行Gensini评分,按照评分分为轻度(0分≤X<18分)、中度(18分≤X<41分)、重度组(X≥41分)。采用多元线性回归分析、多因素Logistic回归分析及ROC曲线研究血清补体C1q与老年患者冠脉狭窄程度之间的相关性。结果:与轻度组相比,中、重度组高密度脂蛋白胆固醇(HDL-C)及左室射血分数(LVEF)明显下降(均P<0.05),三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高敏C反应蛋白(hs-CRP)、糖化血红蛋白(HbAlc)、C1q及左心室舒张末期内径(LVEDd)明显上升(均P<0.05)。相关性分析显示,血清补体C1q与冠脉狭窄程度呈显著正相关(r=0.018,P<0.05),是冠脉狭窄程度的独立预测因子(OR=1.071,95%CI:1.046～1.096,P<0.05)。ROC曲线分析显示,血清补体C1q水平>172.75mg/L的敏感度和特异度分别为89.5%和82.0%,曲线下面积为0.920,具有较好的诊断效能。结论:血清补体C1q作为一种简单、廉价的临床血清学指标,对老年患者冠脉狭窄程度有较好的评估、诊断价值。Objective：To analyze the relationship between serum complement C1 q and severity of coronary artery stenosis in elderly patients.Method：A total of 214 patients（≥65 years old）who were hospitalied in Xiangya Hospital firstly and diagnosed as coronary artery disease were enrolled.After admission,the serum complement C1 q level was determined by immunoturbidimetric assay.Patients were divided into three groups according to the Gensini score：Quartile 1（0≤X〈18）（n=56）,Quartile 2（18≤X〈41）（n=44）and Quartile 3（X≥41）（n=114）.Multiple linear regression analysis,Logistic regression and receiver operating characteristic curve were used to evaluate the relationship of serum complement C1 q and severity of coronary artery stenosis.Result：Compared with Quartile 1,levels of HDL-C and LVEF in Quartile 2 and Quartile 3 were significantly decreased,while TG,TC,LDL-C,hs-CRP,HbAlc,C1 q and LVEDd were increased（all P〈0.05）.The correlation analysis showed that the serum complement C1 q was positively related to the severity of coronary artery stenosis（r=0.018,P〈0.05）.C1 q was an independent predictor of coronary stenosis（OR=1.071,95%CI：1.046-1.096,P〈0.05）.ROC curve showed that the sensitivity was 89.5% and the specificity was 82.0% when the cut off value was 172.75 mg/L,and the AUC was 0.920,prompting agood diagnostic efficacy.Conclusion：Serum complement C1 q is a simple,economic and clinical serologic indicator,which has a good clinical value.

关 键 词：补体C1Q 冠状动脉狭窄 多元线性回归 LOGISTIC回归分析 ROC工作曲线 

分 类 号：R541.4[医药卫生—心血管疾病]