外周循环血中血脂比值Chemerin水平与急性冠脉综合征患者冠状动脉病变程度的相关性分析  

Correlation Analysis of Blood Lipid Ratio Chemerin Level and Severity of Coronary Artery Disease in Patients with Acute Coronary Syndrome

作　　者：赵媛媛 丁振江[1] 田雅楠[1] 付亚磊 樊华 孟兵兵 钱人杰 ZHAO Yuanyuan;DING Zhenjiang;TIAN Yanan(The Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院心血管内科,河北承德067000

出　　处：《河北医学》2021年第7期1141-1147,共7页Hebei Medicine

基　　金：河北省政府资助专科带头人培养项目,(编号:361008)。

摘　　要：目的:探讨急性冠脉综合征患者外周血中各血脂比值及Chemerin水平与冠状动脉病变严重程度的相关性,以及对急性冠脉综合征的临床预测价值。方法:选自2019年7月至2020年1月于我院行冠状动脉造影术检查符合纳入标准者230人,同时收集病历及临床检查资料,分为ACS组(164例)及对照组(66例)。其中ACS组包括:不稳定型心绞痛组(87例)、急性心肌梗死组(77例)。同时将Gensini评分按照三分位法,分为低分组、中分组、高分组三组。分析血脂比值、Chemerin水平在各组间的差异及与冠状动脉病变程度的相关性。结果:通过综合分析发现TC/HDL-c、TG/HDL-c、non-HDL-c/HDL-c、LDL-c/HDL-c、LCI、Chemerin水平ACS组明显高于对照组,且均与冠状动脉病变严重程度存在正相关性(P<0.01),同时Chemerin水平与TC/HDL-c、LDL-c/HDL-c、Non-HDL-c/HDL-c也存在正相关性(P<0.01);通过建立二元Logistic回归模型,发现Chemerin可作为预测发生ACS的独立危险因素(OR=1.03,P<0.01),通过描绘ROC曲线确定了Chemerin在预测ACS的发生的截断值为619.00ng/mL,ROC曲线下面积为0.716。(P<0.001,95%CI:0.649~0.783)。结论:急性冠脉综合征患者外周循环血中各血脂比值及Chemerin水平明显高于对照组,且与Gensini评分呈正相关,同时Chemerin水平的升高可作为预测ACS的独立危险因素,并且对于ACS具有较高的预测价值。Objective:To investigate the relationship between the serum lipid ratio and Chemerin level in patients with acute coronary syndrome(ACS)and the severity of coronary artery disease,to evaluate the clinical predictive value of the ratio of serum lipids and Chemerin level in patients with acute coronary syndrome(ACS).Methods:230 patients who had done the coronary angiography in our hospital from July 2019 to January 2020 were selected that met the inclusion criteria,and their medical records and clinical examination data were collected and divided into ACS group(164 cases)and control group(66 cases).ACS group included unstable angina pectoris group(87 cases)and acute myocardial infarction group(77 cases).At the same time,Gensini score was divided into three groups:low group,medium group and high group.The differences of blood lipid ratio and Chemerin level among the groups and the correlation with the severity of coronary artery disease were analyzed.Results:Comprehensive analysis showed that the levels of TC/HDL-C,TG/HDL-C,non-HDL-C/HDL-C,LDL-C/HDL-C,LCI and Chemerin in ACS group were significantly higher than those in control group,and they were positively correlated with the severity of coronary artery disease(P<0.01),and Chemerin level was also positively correlated with TC/HDL-C,LDL-C/HDL-C,non-HDL-C/HDL-C(P<0.01).By establishing binary logistic regression model,Chemerin was found to be an independent risk factor for ACS(or=1.03,P<0.01).The cut-off value of Chemerin in predicting ACS was 619.00ng/ml and the area under the ROC curve was 0.716(P<0.001,95%CI:0.649~0.783).Conclusion:The serum lipid ratio and Chemerin level in patients with acute coronary syndrome are significantly higher than those in the control group,and they are positively correlated with Gensini score.Meanwhile,the increase of Chemerin level can be used as an independent risk factor to predict ACS,and has high predictive value for ACS.

关 键 词：急性冠脉综合征 GENSINI评分 血脂比值 脂肪因子Chemerin 预测价值 

分 类 号：R541.4[医药卫生—心血管疾病]