出 处:《中国循证心血管医学杂志》2021年第5期604-607,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine
摘 要:目的探讨血清骨钙素水平与冠状动脉粥样硬化性心脏病(冠心病,CAD)患者冠状动脉(冠脉)病变程度及冠脉钙化的相关性。方法选取柳州市人民医院心血管内科疑似CAD患者286例,具有完整资料的受试者作为整体研究,根据冠脉造影结果分为CAD组及Non-CAD组;对CAD患者行冠脉双源螺旋CT扫描,采用Agatston修正法计算冠脉血管钙化积分。并收集受试者一般临床资料,检测血清骨钙素水平。结果CAD组患者血清骨钙素水平低于Non-CAD组[(22.31±6.89)μg/ml vs.(27.23±3.05)μg/ml],且急性冠脉综合征患者血清骨钙素水平低于稳定型心绞痛组患者[(20.35±4.13)μg/ml vs.(23.30±5.44)μg/ml],差异有统计学意义(P<0.05)。校正混杂因素后,经多因素模型分析,血清骨钙素水平≤19.05μg/ml是冠心病发生的独立危险因素(OR=1.59,95%CI:1.00~3.62,P<0.05)。对CAD组患者,多支病变亚组患者血清骨钙素水平低于单支病变亚组患者[(23.83±5.26)μg/ml vs.(20.34±4.25)μg/ml](P<0.05);经Pearson相关性分析,CAD组患者血清骨钙素水平与Gensini评分呈负相关性(r=-0.619,P=0.000);而且随着冠脉钙化程度的加重,血清骨钙素水平逐渐降低(P<0.05)。经多元逐步回归分析,血清骨钙素则是冠脉钙化的独立保护因素(OR=0.454,95%CI:0.147~0.685,P<0.05)。结论CAD患者血清骨钙素水平降低,且与冠脉病变程度及冠脉钙化的发生和发展存在一定相关性,对预测冠脉钙化具有一定参考价值。Objective To investigate the correlation between serum osteocalcin level and the degree of coronary artery lesion and coronary artery calcification in patients with coronary heart disease(CAD).Methods A total of 286 patients with suspected CAD in the Department of Cardiovascular Medicine of Liuzhou People's Hospital were selected as the whole study,and the subjects with complete data were divided into CAD group and Non-CAD group according to the results of coronary angiography.Coronary artery dual-source spiral CT scanning was performed in CAD patients,and the coronary artery calcification score was calculated by Agatston correction method.In addition,general clinical data of subjects were collected to detect serum osteocalcin level.Results The serum osteocalcin level in CAD group was lower than that in Non-CAD group[(22.31±6.89)μg/ml vs.(27.23±3.05)μg/ml],and the serum osteocalcin level in patients with acute coronary syndrome was lower than that in patients with stable angina[(20.35±4.13)μg/ml vs.(23.30±5.44)μg/ml],the difference was statistically significant(P<0.05).After adjusting for confounding factors,the multivariate model analysis showed that serum osteocalcin level<19.05 ug/ml was an independent risk factor for the occurrence of coronary heart disease(OR=1.59,95%CI:1.00~3.62,P<0.05).For patients with CAD,serum osteocalcin levels in the multivessel disease subgroup were lower than those in the single vessel disease subgroup[(23.83±5.26)ug/ml vs.(20.34±4.25)g/ml](P<0.05);Pearson correlation analysis showed that serum osteocalcin level was negatively correlated with Gensini score in CAD patients(r=-0.619,P=0.000);and serum osteocalcin level gradually decreased with the aggravation of coronary artery calcification(P<0.05).By multiple stepwise regression analysis,serum osteocalcin was an independent protective factor for coronary artery calcification(OR=0.454,95%CI:0.147~0.685,P<0.05).Conclusion The serum osteocalcin level is decreased in CAD patients,and there is a certain correlation with the deg
关 键 词:血清骨钙素 冠状动脉病变程度 冠状动脉钙化 冠状血管造影术
分 类 号:R543.3[医药卫生—心血管疾病]
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