联合检测生长分化因子-15和骨保护素血清水平及颈动脉粥样硬化评分评估冠状动脉病变程度的临床研究  

Clinical study of combined detection of growth differentiation factor-15, osteoprotegerin serum levels and carotid atherosclerosis score in the assessment of coronary artery disease

作　　者：栗昌 周江[2] 郭靖涛[2] 罗东雷[2] 侯天华[2] 刘波[2] LI Chang;ZHOU Jiang;GUO Jing-tao;LUO Dong-lei;HOU Tian-hua;LIU Bo(Graduate School of Chengde Medical University,Chengde 067000,China;Department of Cardiology,Chengde Central Hospital,Chengde 067000,China)

机构地区：[1]承德医学院研究生学院,河北省承德市067000 [2]承德市中心医院心内科

出　　处：《中国心血管病研究》2019年第4期326-330,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的通过联合检测生长分化因子-15(growth differentiation factor-15,GDF-15)、骨保护素(osteoprotegerin,OPG)血清水平及颈动脉粥样硬化评分参数,探讨评估急性冠状动脉综合征(acute coronary syndrome,ACS)患者冠状动脉病变严重程度的方法.方法随机选取2017年8月至2018年8月在承德市中心医院行冠状动脉造影检查证实为ACS的患者50例为试验组,随机选取同期于我院行冠状动脉造影正常的患者50例为对照组.于造影术前1h抽取两组患者肘静脉血,采用ELISA法分别测定血清GDF-15、OPG水平,术后分别于我院超声科测量颈动脉形态学指标,对比两组血清GDF-15、OPG及颈动脉形态学指标是否有统计学差异,并探究以上指标是否与冠状动脉造影SYNTAX评分具有相关性.结果①血清GDF-15水平:试验组为(679.10±559.38)ng/L,对照组为(370.18±201.19)ng/L;血清OPG水平:试验组为(866.44±659.26)ng/L,对照组为(474.48±228.25)ng/L;Crouse评分:试验组为(6.40±4.67)分,对照组为(1.47±1.69)分.两组以上三组参数对比后提示试验组显著高于对照组,差异具有统计学意义(P<0.05).②试验组中低危组、中危组、高危组血清GDF-15水平分别为(425.73±152.38)ng/L、(925.51±216.30)ng/L和(1675.19±901.79)ng/L;血清OPG水平分别为(593.58±209.06)ng/L、(1129.61±663.17)ng/L和(2063.36±945.22)ng/L;Crouse评分分别为(4.37±3.07)分、(10.56±3.14)分和(14.01±1.93)分.以上指标与SYNTAX评分均呈正相关.③联合检测的曲线下面积(0.918)大于单独检测GDF-15的曲线下面积(0.724)与单独检测OPG的曲线下面积(0.735)和单独检测Crouse评分的曲线下面积(0.834).结论 ACS患者的GDF-15、OPG血清水平及颈动脉形态学指标显著升高,且联合检测GDF-15、OPG血清水平及颈动脉形态学指标可更好地评估ACS患者的冠状动脉病变程度.Objective To evaluate the severity of coronary artery lesions in patients with acute coronary syndrome (ACS) by combined detection of growth differentiation factor-15 (GDF-15), osteoprotegerin (OPG) serum levels and cervical atherosclerosis score parameters. Methods A total of 50 patients with ACS confirmed by coronary angiography in Chengde Central Hospital from August 2017 to August 2018 were randomly selected as the experimental group. 50 patients with normal coronary angiography in Chengde Central Hospital were randomly selected as the control group. Elbow venous blood was taken from the two groups 1 hour before angiography. Serum GDF-15, OPG levels were measured by ELISA. The morphological parameters of the neck artery were measured in the Department of Ultrasound in Chengde Central Hospital. The serum GDF-15, OPG and the morphological parameters of the neck artery were compared between the two groups and whether the above indicators were correlated with the coronary angiography SYNTAX score were analyzed. Results (l)Serum GDF-15 level:(679.10±559.38) ng/L in the experimental group,(370.18±201.19) ng/L in the control group;serum OPG:( 866.44±659.26) ng/L in the experimental group and (474.48±228.25)ng/L in the control group;Crouse score:(6.40 ± 4.67) points in the experimental group and (1.47 ± 1.69) points in the control group. Comparing the parameters above between 2 groups, the experimental group's were significantly higher than the control group's and the differences were statistically significant (P<0.05).(2)The serum GDF-15 levels in the lowrisk group, the middle-risk group and the high-risk group were (425.73±152.38)ng/L,(925.51 ±216.30)ng/L and ( 1675.19±901.79 )ng/L respectively;the serum OPG levels were ( 593.58±209.06)ng/L,( 1129.61±663.17) ng/L and (2063.36±945.22)ng/L respectively;Crouse scores were (4.37±3.07),(10.56±3.14) and (14.01 ± 1.93 ) respectively. All the above indicators were positively correlated with SYNTAX score.(3)The area under the curve of the combined detection (

关 键 词：生长分化因子-15 骨保护素 SYNTAX评分 颈动脉粥样硬化评分 急性冠状动脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]