基因表达评分(GES)对非糖尿病人群冠状动脉狭窄程度的预测价值  

Predictive value of gene expression score(GES) on the degree of coronary artery stenosis in non-diabetic patients

作　　者：张亮[1] 石宇杰[2] 高鹏 张淑丽 王中鲁 董红玲 张健[1] ZHANG Liang;SHI Yu-jie;GAO Peng;ZHANG Shu-li;WANG Zhong-lu;DONG Hong-ling;ZHANG Jian(Department of Cardiology, Clinical College of PLA Army General Hospital of Anhui Medical University,Beijing, 100700, China)

机构地区：[1]安徽医科大学陆军总医院临床学院心内科,北京100700 [2]中国人民解放军陆军总医院心内科,北京100700 [3]北京爱普益医学检验中心有限公司,北京100700

出　　处：《中国循证心血管医学杂志》2017年第3期314-316,320,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨和评价外周血基因表达评分对非糖尿病人群冠状动脉狭窄程度的预测价值。方法连续入选2015年11月~2016年4月于陆军总医院心血管病研究所住院的146例非糖尿病可疑胸痛患者,其中男性92例,女性54例。对146例患者行冠状动脉造影检查,并使用Lepcare检测方法测定基因表达评分(分值范围-30~30分),使用统计方法验证基因表达评分作为新的检测方法评估冠状动脉狭窄程度的可行性,并分析基因表达评分与冠状动脉狭窄程度的相关性。结果以冠状动脉造影结果为金标准,基因表达评分阈值设为6分时,Lep Care评分预测冠状动脉狭窄程度≥50%的患者的ROC曲线下面积(AUC)为0.869±0.033(95%CI:0.803~0.934,P<0.01),其灵敏度为91.8%,特异性为70.8%。冠状动脉狭窄≥50%的患者在-30到-1、-10到10、11到30组中的比例分别为0(0%)、20(43%)、78(88%),且随基因表达评分愈高,冠状动脉狭窄程度愈高。结论基因表达评分作为无创性检查,在预测非糖尿病人群冠状动脉狭窄程度中具有较高的临床应用价值。Objective To explore and evaluate the value of peripheral blood gene expression score in predicting the degree of coronary artery stenosis in nondiabetic patients. Methods The in-hospital patients (n=146,including 92 males and 54 females) were chosen from Nov.2015 to Apr.2016. All patients were given examinations of coronary angiography (CAG) and LepCare to validate gene expression score (GES) feasibility (score range -30 to 30) as a new method to evaluate the degree of coronary stenosis and analyze the correlation between a peripheral GES and coronary artery stenosis degree. Results Based on the results of coronary angiography as the gold standard, and when the GES threshold was set at6 points, the area under the ROC curve (AUC) in patients with coronary artery stenosis ≥50% predicted by LepCare score was 0.869±0.033 (95%CI: 0.803~0.934, P<0.01). The sensitivity was 91.8% and the specificity was 70.8%. The proportion of patients with coronary artery stenosis ≥50% was 0 (0%), 20 (43%), 78 (88%) in the range of -30 to -1, -10 to 10, and the higher the gene expression score, the higher the degree of coronary artery stenosis. Conclusions As a noninvasive method, GES has a high clinical value in predicting the degree of coronary artery stenosis in nondiabetic patients.

关 键 词：基因检测 基因表达评分 非糖尿病人群 冠心病 预测价值 

分 类 号：R541.4[医药卫生—心血管疾病]