冠状动脉粥样硬化性心脏病患者血清骨形态发生蛋白4,N1-甲基烟酰胺和血管生成素样蛋白8水平检测的临床意义  

Clinical Significance of Detection of Serum Bone Morphogenetic Protein 4,N1-Methylnicotinamide and Angiopoietin-Like Protein 8 Levels in Patients with Coronary Atherosclerotic Heart Disease

作　　者：关小明[1] 陈锴[2] 王文会[3] GUAN Xiao-ming;CHEN Kai;LIANG Wen-hui(Department of Clinical Laboratory,Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan 528000,China;Department of Internal Medicine,Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan 528000,China;Department of Internal Medicine-Neurology,Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan 528000,China)

机构地区：[1]佛山市中医院检验科,广东佛山528000 [2]佛山市中医院内科,广东佛山528000 [3]佛山市中医院心血管内科,广东佛山528000

出　　处：《现代检验医学杂志》2021年第4期15-20,共6页Journal of Modern Laboratory Medicine

基　　金：2017年度广东省医学科研基金项目(2017G0195)。

摘　　要：目的研究冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)患者血清骨形态发生蛋白4(bone morphogenetic protein 4,BMP-4),N1-甲基烟酰胺(N1-methylnicotinamide,me-Nam)和血管生成素样蛋白8(angiopoietinlike protein 8,ANGPTL8)水平检测的临床意义。方法选取2018年1月~2020年1月佛山市中医院诊治的86例CHD患者作为CHD组,以健康体检的60例健康人群为对照组,检测CHD组及对照组血清BMP-4,me-Nam,ANGPTL8,血脂及炎症因子水平。比较不同冠状动脉狭窄程度、不同病变支数患者血清BMP-4,me-Nam及ANGPTL8水平。Pearson线性相关分析CHD组患者血清BMP-4,me-Nam和ANGPTL8之间的相关性及三者与Gensini积分、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和超敏C反应蛋白(hs-CRP)的相关性。ROC曲线分析血清BMP-4,me-Nam,ANGPTL8及联合检测对CHD组患者的诊断价值。结果与对照组相比,CHD组患者高血压史、糖尿病史占比较高,TC,TG,LDL-C,IL-6,TNF-α及hs-CRP水平明显增高,HDL-C水平明显降低,差异均有统计学意义(t=5.950~28.084,均P<0.05)。与对照组相比,CHD组患者血清BMP-4,me-Nam,ANGPTL8水平明显增高,差异均有统计学意义(t=14.201,13.495,37.538,均P<0.05)。随着Gensini积分升高或病变支数的增加,CHD患者的血清BMP-4,me-Nam,ANGPTL8有逐渐升高的趋势(χ^(2)=80.976,75.688,108.641,均P<0.05)。CHD患者血清BMP-4表达与me-Nam,ANGPTL8表达呈显著正相关(r=0.567,0.610,均P<0.05),me-Nam与ANGPTL8的表达呈显著正相关(r=0.562,P=0.000)。血清BMP-4,me-Nam,ANGPTL8及联合检测的曲线下面积分别为0.707(95%CI:0.601~0.812),0.713(95%CI:0.612~0.833),0.759(95%CI:0.667~0.850)及0.847(95%CI:0.722~0.908),联合诊断的诊断效能大于任一单一指标的诊断效能。结论CHD患者血清BMP-4,me-Nam及ANGPTL8水平升高,三者与血脂、炎症因子、冠状动脉狭窄程度及病变支数有关,检�Objective To study the clinical significance of detection of serum bone morphogenetic protein 4(BMP-4),N1-methylnicotinamide(me-Nam)and angiopoietin-like protein 8 levels in patients with coronary heart disease(CHD).Methods A total of 86 patients with CHD diagnosed and treated in Foshan Hospital of Traditional Chinese Medicine from January 2018 to January 2020 were selected as the CHD group,and 60 healthy people who received physical examination were selected as the control group.The serum BMP-4,me-Nam,ANGPTL8,blood lipids and inflammatory factors levels in CHD group and control group were detected.The serum BMP-4,me-Nam and ANGPTL8 levels were compared among patients with different degree of coronary artery stenosis and different number of coronary artery lesions.Pearson linear correlation analysis was used to analyze the correlation of serum BMP-4,me-Nam,ANGPTL8 and their relationship with Gensini score,total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein(HDL-C),low-density lipoprotein(LDL-C),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)in CHD group.The ROC curve was used to analyze the diagnostic value of serum BMP-4,me-Nam,ANGPTL8 and combined detection for CHD patients.Results Compared with the control group,the proportion of hypertension history were history the levels of TC,TG,LDL-C,IL-6,TNF-αand hs-CRP were significantly higher in the CHD group,and the levels of HDL-C was significantly lower,the differences were statistically significant(t=5.950~28.084,all P<0.05).Compared with the control group,the serum BMP-4,me-Nam and ANGPTL8 levels were significantly higher in the CHD group,the differences were statisitically significant(t=14.201,13.495,37.538,all P<0.05).With the increase of Gensini score or the increase of the number of lesions,the serum BMP-4,me-Nam,and ANGPTL8 of patients with CHD had a gradually increasing trend(χ^(2)=80.976,75.688,108.641,all P<0.05).The expression of serum BMP-4 in CHD patients was significantly positively corr

关 键 词：冠心病 骨形态发生蛋白4 N1-甲基烟酰胺 血管生成素样蛋白8 血脂 炎症因子 冠脉病变 

分 类 号：R541.4[医药卫生—心血管疾病] R392.11[医药卫生—内科学]