血清组织型纤溶酶原激活物-抑制剂复合物和膜联蛋白A2及核转录过氧化物酶增殖体激活受体γ与冠心病患者冠状动脉狭窄程度相关性及其对预后的影响  

Correlations of serum tissue plasminogen activator inhibitor complex,annexinⅡand peroxisome proliferator activated receptor-gamma with coronary artery stenosis in patients with coronary heart disease and their influences on prognosis

作　　者：宋小丽[1] SONG Xiao-li(Department of Functional Medicine,Puyang Oilfield General Hospital,Puyang,Henan 457000,China)

机构地区：[1]濮阳市油田总医院功能科,河南濮阳457000

出　　处：《中华实用诊断与治疗杂志》2021年第6期556-560,共5页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划项目(2018031355)。

摘　　要：目的观察冠心病患者血清组织型纤溶酶原激活物-抑制剂复合物(tissue plasminogen activator inhibitor complex,t-PAIC)、膜联蛋白A2(annexinⅡ)、核转录过氧化物酶增殖体激活受体γ(peroxisome proliferator activated receptor-gamma,PPARγ)水平,探讨其与冠心病患者冠状动脉狭窄程度相关性及其对预后的影响。方法冠心病患者102例为冠心病组,体检健康者102例为对照组。冠心病组根据冠状动脉狭窄程度分为轻度组(Gensini评分<18分)30例,中度组(Gensini评分18~40分)45例,重度组(Gensini评分>40分)27例。比较冠心病组与对照组及轻、中、重度组血清t-PAIC、annexinⅡ、PPARγ水平。采用Pearson相关性分析血清t-PAIC、annexinⅡ、PPARγ水平之间的相关性及其与冠状动脉狭窄程度的相关性。冠心病组随访3个月,根据预后情况分为预后不良组24例和预后良好组78例,比较2组临床资料及血清t-PAIC、annexinⅡ、PPARγ水平;冠心病患者预后不良的影响因素采用多因素Cox比例风险回归模型分析;绘制ROC曲线,评估血清t-PAIC、annexinⅡ、PPARγ水平对冠心病患者预后不良的预测效能。结果冠心病组血清t-PAIC、annexinⅡ、PPARγ水平[(13.01±3.29)ng/L、(2.23±0.64)ng/L、(2.44±0.75)mg/L]均高于对照组[(7.92±2.07)ng/L、(1.56±0.30)ng/L、(1.06±0.32)mg/L](P<0.05);轻、中、重度组血清t-PAIC、annexinⅡ、PPARγ水平依次增高(P<0.05);血清t-PAIC、annexinⅡ、PPARγ水平与Gensini评分呈正相关(r=0.750,P<0.001;r=0.593,P<0.001;r=0.782,P<0.001),血清t-PAIC与annexinⅡ、PPARγ呈正相关(r=0.644,P<0.001;r=0.531,P<0.001),annexinⅡ与PPARγ呈正相关(r=0.762,P<0.001)。预后不良组冠状动脉单支病变比率(4.17%)、左室射血分数[(52.23±4.18)%]均低于预后良好组[35.90%、(57.31±5.15)%](P<0.05),冠状动脉双支病变比率(37.50%)、冠状动脉多支病变比率(58.33%)、左心室舒张末期内径[(43.76±2.24)mm]、血清t-PAIC[(16.25±3.56)ng/L]、annexinⅡ[Objective To observe the levels of serum tissue plasminogen activator-inhibitor complex(t-PAIC),annexinⅡand peroxisome proliferator activated receptor-gamma(PPARγ)in patients with coronary heart disease(CHD),and to investigate their correlations with the degree of coronary artery stenosis and their influences on prognosis.Methods Totally 102 patients with CHD(CHD group)were divided into 30 patients with Gensini score of<18(mild coronary artery stenosis group),45 patients with Gensini score of 18 to 40(moderate coronary artery stenosis group)and 27 patients with Gensini score of>40(severe coronary artery stenosis group).And another 102 healthy volunteers were as controls(control group).The levels of serum t-PAIC,annexinⅡand PPARγwere compared between CHD group and control group and among mild,moderate and severe coronary artery stenosis groups.Pearson correlation was used to analyze the correlations among serum t-PAIC,annexinⅡand PPARγlevels as well as the their correlations with the degree of coronary artery stenosis.CHD group was followed up for 3 months,and were divided into poor prognosis group(n=24)and good prognosis group(n=78).The clinical data and the levels of serum t-PAIC,annexinⅡand PPARγwere compared between good and poor prognosis groups.Cox proportional hazard regression model was used to analyze the influencing factors of poor prognosis of CHD.ROC curve was drawn to evaluate the efficiencies of serum t-PAIC,annexinⅡand PPARγlevels on predicting poor prognosis.Results The levels of serum t-PAIC,annexinⅡand PPARγwere higher in CHD group((13.01±3.29)ng/L,(2.23±0.64)ng/L,(2.24±0.75)mg/L)than those in control group((7.92±2.07)ng/L,(1.56±0.30)ng/L,(1.06±0.32)mg/L)(P<0.05),and increased gradually in turn in mild,moderate and severe coronary artery stenosis groups(P<0.05).The levels of serum t-PAIC,annexinⅡand PPARγwere positively correlated with Gensini score(r=0.750,P<0.001;r=0.593,P<0.001;r=0.782,P<0.001),the serum t-PAIC level was positively correlated with annexinⅡand PPAR�

关 键 词：冠心病 冠状动脉狭窄程度 组织型纤溶酶原激活物-抑制剂复合物 膜联蛋白A2 核转录过氧化物酶增殖体激活受体γ 主要不良心脏事件 

分 类 号：R541.4[医药卫生—心血管疾病]