血清淀粉样蛋白A和一氧化氮在冠心病患者心功能和心血管事件评估中的应用价值  

Application Values of Serum Amyloid A and Nitric Oxide in Assessment of Cardiac Function and Cardiovascular Events in Patients with Coronary Heart Disease

作　　者：那轩与 范越男 彭程 王柏山[1] 张程[1] NA Xuan-yu;FAN Yue-nan;PENG Cheng;WANG Bai-shan;ZHANG Cheng(Department of Clinical Laboratory,the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110031,China)

机构地区：[1]辽宁中医药大学附属医院检验科,沈阳110031

出　　处：《临床误诊误治》2021年第9期45-48,54,共5页Clinical Misdiagnosis & Mistherapy

基　　金：辽宁省科学技术计划项目(2018055095)。

摘　　要：目的探讨血清淀粉样蛋白A和一氧化氮在冠心病患者心功能和心血管事件评估中的应用价值。方法选取2018年1月—2019年12月诊治的冠心病80例作为冠心病组,并按照心功能情况将其分为左心室射血分数(LVEF)<50%组(68例)和LVEF≥50%组(12例),按照心血管事件情况将其分为有心血管事件组(17例)和无心血管事件组(63)例,另选取同期健康体检者30例作为健康体检组。观察比较冠心病组与健康体检组、LVEF<50%组与LVEF≥50%组、有心血管事件组与无心血管事件组相关检测指标水平,分析冠心病患者LVEF和心血管事件分别与血清淀粉样蛋白A、一氧化氮的相关性,探讨冠心病患者血清淀粉样蛋白A和一氧化氮水平与心血管事件风险的相关性。结果冠心病组LVEF和一氧化氮低于健康体检组,血清淀粉样蛋白A、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、肌钙蛋白I、肌红蛋白和肌酸激酶同工酶高于健康体检组;LVEF<50%组血清淀粉样蛋白A高于LVEF≥50%组,一氧化氮低于LVEF≥50%组;有心血管事件组LVEF和一氧化氮低于无心血管事件组,血清淀粉样蛋白A高于无心血管事件组,差异有统计学意义(P<0.05或P<0.01)。Pearson相关性分析结果显示,冠心病患者LVEF与血清淀粉样蛋白A呈负相关,与一氧化氮呈正相关;心血管事件与血清淀粉样蛋白A呈正相关,与一氧化氮呈负相关(P<0.05)。Cox回归分析结果显示,冠心病患者血清淀粉样蛋白A每增加1 mg/L,未校正时发生心血管事件风险增加48%,校正年龄和性别时发生心血管事件风险增加27%,校正总胆固醇、三酰甘油和肌钙蛋白I时发生心血管事件风险增加3%;一氧化氮每增加1μmol/L,未校正时发生心血管事件风险降低22%,校正年龄和性别时发生心血管事件风险降低11%,校正总胆固醇、三酰甘油和肌钙蛋白I时发生心血管事件风险降低8%(P<0.05或P<0.01)。结论血清淀粉样蛋白A和一�Objective To explore application values of serum amyloid A(SAA)and nitric oxide in assessment of cardiac function and cardiovascular events in patients with coronary heart disease(CHD).Methods A total of 80 patients with CHD diagnosed and treated between January 2018 and December 2019 were selected as CHD group,and the patients were divided into left ventricular ejection fraction(LVEF)less than 50%subgroup(n=68)and LVEF equal or more than 50%subgroup(n=12)according to cardiac function conditions;according to conditions of cardiovascular events,they were divided into cardiovascular event subgroup(n=17)and non-cardiovascular event subgroup(n=63).In addition,30 people who had undergone physical examinations at the same period were selected as health physical examination group.Levels of related indicators were compared between CHD group and the healthy physical examination group,between LVEF less than 50%subgroup and LVEF equal or more than 50%subgroup,and between cardiovascular event subgroup and non-cardiovascular event subgroup.Correlations between LVEF and cardiovascular events respectively with serum SAA and nitric oxide in patients with CHD were analyzed.Correlations between levels of SAA and nitric oxide in patients with CHD with the risk of cardiovascular events were explored.Results In CHD group,levels of LVEF and nitric oxide were significantly lower,while levels of SAA,total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),troponin I,myoglobin and creatine kinase isoenzymes were significantly higher than those in health physical examination group;in LVEF less than 50%subgroup,SAA level was significantly higher than that in LVEF equal or more than 50%subgroup,while nitric oxide level was significantly lower than that in LVEF equal or more than 50%subgroup;in cardiovascular event subgroup,levels of LVEF and nitric oxide were significantly lower than those in non-cardiovascular event subgroup,while SAA level was significantly higher than that in non-cardiovascular event subgroup,

关 键 词：冠心病 血清淀粉样蛋白A 一氧化氮 心功能 左心室射血分数 心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]