血清白介素17、降钙素原及超敏C反应蛋白水平对冠状动脉重度狭窄患者冠状动脉侧支循环形成不良的诊断价值研究  

Diagnostic Value of Serum Levels of IL-17,PCT and hs-CRP on Poor Coronary Artery Collateral Circulation in Patients with Severe Coronary Stenosis

作　　者：朱婕 曹永涛 车红梅 宋文静[1] 刘玮[1] 刘兴芝 曹晓莉 ZHU Jie;CAO Yong-tao;CHE Hong-mei;SONG Wen-jing;LIU Wei;LIU Xing-zhi;CAO Xiao-li(The Second Department of Cardiovascular Medicine,the Fourth People's Hospital of Hengshui,Hengshui 053000,China;Department of Internal Medicine,Maternal and Child Care Service Center of Dingzhou,Dingzhou 073000,China)

机构地区：[1]河北省衡水市第四人民医院心血管内二科,053000 [2]河北省定州市妇幼保健院内科,073000

出　　处：《实用心脑肺血管病杂志》2018年第6期15-18,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：衡水市科技计划项目(216014062Z)

摘　　要：目的分析血清白介素17(IL-17)、降钙素原(PCT)及超敏C反应蛋白(hs-CRP)水平对冠状动脉重度狭窄患者冠状动脉侧支循环形成不良的诊断价值。方法选取2017年1—6月衡水市第四人民医院心血管内二科收治的冠状动脉重度狭窄患者120例,根据冠状动脉侧支循环形成情况分为良好组67例(Rentrop分级Ⅱ～Ⅲ级)和不良组53例(Rentrop分级0～Ⅰ级)。比较两组患者临床资料及血清IL-17、PCT、hs-CRP水平,绘制ROC曲线并设计平行诊断试验以评价血清IL-17、PCT、hs-CRP水平对冠状动脉重度狭窄患者冠状动脉侧支循环形成不良的诊断价值。结果两组患者性别、年龄、体质量、高血压发生率、糖尿病发生率、吸烟率、心率、收缩压、三酰甘油及总胆固醇比较,差异无统计学意义(P>0.05)。良好组患者血清IL-17、PCT、hs-CRP水平低于不良组(P<0.05)。ROC曲线结果显示,血清IL-17水平诊断冠状动脉重度狭窄患者冠状动脉侧支循环形成不良的曲线下面积(AUC)为0.770[95%CI(0.681,0.859)],最佳截断值为9.11 ng/L,灵敏度为81.5%,特异度为78.7%;血清PCT水平诊断冠状动脉重度狭窄患者冠状动脉侧支循环形成不良的AUC为0.775[95%CI(0.687,0.863)],最佳截断值为0.036μg/L,灵敏度为73.7%,特异度为75.6%;血清hs-CRP水平诊断冠状动脉重度狭窄患者冠状动脉侧支循环形成不良的AUC为0.750[95%CI(0.654,0.846)],最佳截断值为2.96 mg/L,灵敏度为84.2%,特异度为73.0%。以血清IL-17、PCT、hs-CRP任一指标水平≥最佳截断值为阳性设计平行诊断试验,结果显示,三者平行试验诊断冠状动脉重度狭窄患者冠状动脉侧支循环形成不良的灵敏度为99.2%,特异度为43.4%。结论血清IL-17、PCT、hs-CRP水平对冠状动脉重度狭窄患者冠状动脉侧支循环形成不良的诊断价值中等,但三者平行试验可明显降低漏诊率。Objective To analyze the diagnostic value of serum levels of IL-17,PCT and hs-CRP on poor coronary artery collateral circulation in patients with severe coronary stenosis.Methods From January to June in 2017,a total of 120 patients with severe coronary stenosis were selected in the Second Department of Cardiovascular Medicine,the Fourth People's Hospital of Hengshui,and they were divided into A group(withⅡ-toⅢ-Rentrop grade,n=67)and B group(with 0-toⅠ-Rentrop grade,n=53)according to the coronary artery collateral circulation status.Clinical data,serum levels of IL-17,PCT and hs-CRP were compared between the two groups,ROC curve and parallel diagnostic test were used to evaluate the diagnostic value of serum levels of IL-17,PCT and hs-CRP on poor coronary artery collateral circulation in patients with severe coronary stenosis.Results No statistically significant differences of gender,age,body weight,incidence of hypertension or diabetes,smoking rate,heart rate,SBP,TG or TC was found between the two groups(P>0.05).Serum levels of IL-17,PCT and hsCRP in A group were statistically significantly lower than those in B group(P<0.05).ROC curve analysis results showed that,AUC of serum IL-17 level in predicting poor coronary artery collateral circulation in patients with severe coronary stenosis was 0.770〔95%CI(0.681,0.859)〕,the optimum truncation value was 9.11 ng/L,the sensitivity was 81.5%,the specificity was 78.7%;AUC of serum PCT level in predicting poor coronary artery collateral circulation in patients with severe coronary stenosis was 0.775〔95%CI(0.687,0.863)〕,the optimum truncation value was 0.036μg/L,the sensitivity was 73.7%,the specificity was 75.6%;AUC of serum hs-CRP level in predicting poor coronary artery collateral circulation in patients with severe coronary stenosis was 0.750〔95%CI(0.654,0.846)〕,the optimum truncation value was 2.96 mg/L,the sensitivity was 84.2%,the specificity was 73.0%.Parallel diagnostic test(each of serum levels of IL-17,PCT and hs-CRP equal or over optimum trunc

关 键 词：冠状动脉狭窄 侧支循环 白介素17 降钙素原 超敏C反应蛋白 

分 类 号：R543.3[医药卫生—心血管疾病]