血清sCD14、sCD163水平与冠状动脉粥样硬化病变程度及稳定性的相关性  

Correlations of the levels of serum sCD14 and sCD163 with the degree,stability of coronary atherosclerosis

作　　者：寇朴怀 苗建玲 KOU Pu-huai;MIAO Jian-ling(Department of Cardiovascular Medicine,Chang'an Hospital,Xi'an 710016,Shaanxi,CHINA)

机构地区：[1]长安医院心血管内科,陕西西安710016

出　　处：《海南医学》2021年第15期1915-1918,共4页Hainan Medical Journal

基　　金：陕西省西安市科学技术协会青年人才托举项目(编号:2019SF-6)。

摘　　要：目的检测可溶性CD14(sCD14)、可溶性CD163(sCD163)在冠状动脉粥样硬化(CAS)患者中的表达水平,并探讨其与CAS病变程度及稳定性的相关性。方法前瞻性选取2019年1月至2020年10月经长安医院心血管内科确诊的216例CAS患者作为观察组,选取同期体检健康人群240例作为对照组,比较现两组受检者的一般资料和sCD14、sCD163、白细胞介素-6(IL-6)水平。将观察组患者分为不稳定型心绞痛(UAP)组104例、稳定型心绞痛(SAP)组69例、急性心肌梗死(AMI)组43例,比较三组患者的Gensini积分、血清sCD14、sCD163、IL-6的表达水平;采用Pearson相关法分析CAS患者血清sCD14、sCD163与IL-6表达水平的相关性;采用受试者工作特征曲线(ROC)曲线分析血清sCD14、sCD163表达对CAS的诊断价值。结果观察组和对照组受检者的年龄、体质量指数比较差异均无统计学意义(P>0.05),而观察组患者的总胆固醇水平及男性、吸烟、高血压、糖尿病比例明显高于对照组,差异均有统计学意义(P<0.05);观察组患者的血清sCD14、sCD163、IL-6表达水平明显高于对照组,差异均有统计学意义(P<0.05);UAP组、AMI组患者血清sCD14、sCD163、IL-6表达水平及Gensini积分明显高于SAP组,AMI组又明显高于UAP组,差异均有统计学意义(P<0.05);经Pearson相关法分析结果显示,CAS患者血清sCD14与sCD163表达水平呈正相关(r=0.716,P<0.05);血清sCD14、sCD163分别与IL-6表达水平呈正相关(r=0.833、0.606,P<0.05);以血清sCD14、sCD163水平为检测变量绘制ROC曲线,sCD14诊断CAS的ROC曲线下面积为0.904(95%CI:0.877-0.931),截断值为3.60μg/mL,灵敏度为75.0%,特异性为90.4%;sCD163诊断CAS的ROC曲线下面积为0.821(95%CI:0.784-0.859),截断值为0.76μg/mL,灵敏度为71.8%,特异性为74.2%。结论血清sCD14、sCD163在CAS中呈高表达,两者有一定相关性,可作为诊断CAS的临床指标。Objective To detect the expression levels of soluble CD14(sCD14)and soluble CD163(sCD163)in patients with coronary atherosclerosis(CAS),and to explore their correlations with the severity and stability of CAS.Methods A total of 216 CAS patients diagnosed in Department of Cardiovascular Medicine,Chang'an Hospital from January 2019 to October 2020 were selected as the observation group,and 240 healthy people who underwent physical examination were selected as the control group.The general data and sCD14,sCD163,and interleukin-6(IL-6)levels in serum of the observation and control groups of subjects were compared.The patients in the observation group were di-vided into unstable angina pectoris(UAP)group(104 cases),stable angina pectoris(SAP)group(69 cases)and acute myocardial infarction(AMI)group(43 cases),and the Gensini scores of the three groups were observed.The expression levels of sCD14,sCD163 and IL-6 in serum were determined by enzyme-linked immunosorbent assay(ELISA).Pear-son method was used to analyze the correlation between serum sCD14,sCD163 and IL-6 expression in patients with CAS.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum sCD14 and sCD163 expression in CAS.Results There was no significant difference in age and body mass index between the two groups(P>0.05).The total cholesterol level and the proportion of male,smoking,hypertension and diabetes in the obser-vation group were significantly higher than those in the control group(all P<0.05).The expression levels of serum sCD14,sCD163 and IL-6 in the observation group were significantly higher than those in the control group(all P<0.05).The expression levels of serum sCD14,sCD163,IL-6 and Gensini points in UAP group and AMI group were significant-ly higher than those in SAP group,and AMI group was significantly higher than UAP group(all P<0.05).Pearson analy-sis showed that there was a positive correlation between the expressions of sCD14 and sCD163 in patients with CAS(r=0.716,P<0.05);and serum sCD14 and s

关 键 词：冠状动脉粥样硬化 可溶性白细胞分化抗原14亚型 可溶性单核巨噬细胞血红蛋白清道夫受体 相关性 

分 类 号：R541.4[医药卫生—心血管疾病]