糖基化载脂蛋白A-I和肾损伤因子-1联合检测对冠心病诊断价值的初步研究  

Preliminary study on diagnostic value of combined detection of gly-ApoA-I and KIM-1 in the coronary heart disease

作　　者：李长平 朱亚文 余翠 张明茹 陈忠[1,2] LI Changping;ZHU Yawen;YU Cui;ZHANG Mingru;CHEN Zhong(Department of Cardiology,the Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200233,China;College of Fisheries and Life Science,Shanghai Ocean University,Shanghai 201306,China;Department of Cardiology,Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China)

机构地区：[1]上海交通大学附属第六人民医院心血管内科,上海200233 [2]上海海洋大学水产与生命学院,上海201306 [3]复旦大学附属中山医院心血管内科,上海200032

出　　处：《国际检验医学杂志》2021年第19期2403-2406,共4页International Journal of Laboratory Medicine

基　　金：上海申康医院发展中心科研项目(SHDC12017X24);上海市浦东新区科经委科研项目(PKJ2018-Y53)。

摘　　要：目的探讨糖基化载脂蛋白A-I(gly-ApoA-I)和肾损伤因子-1(KIM-1)联合检测对冠状动脉粥样硬化性心脏病(简称冠心病)的诊断价值及临床意义。方法检测136例冠心病患者(病例组)和50例非冠心病患者(对照组)血浆gly-ApoA-I和KIM-1水平,分析2项指标。将病例组分为稳定性心绞痛(SAP)组、不稳定性心绞痛(UAP)组和急性心肌梗死(AMI)组,分析3组与对照组间gly-ApoA-I和KIM-1水平差异。绘制受试者工作特征(ROC)曲线,评价gly-ApoA-I和KIM-1对冠心病的辅助诊断效能。结果与对照组比较,病例组2型糖尿病及吸烟比例更高,KIM-1、gly-ApoA-I水平升高(P<0.05)。与对照组比较,SAP组、UAP组和AMI组gly-ApoA-I和KIM-1水平明显升高(P<0.05)。与SAP组比较,UAP组和AMI组gly-ApoA-I和KIM-1水平明显升高(P<0.05)。与UAP组比较,AMI组gly-ApoA-I和KIM-1水平明显升高(P<0.05)。相关性分析显示,gly-ApoA-I与KIM-1水平呈正相关(r=0.788,P<0.05)。ROC曲线分析显示,gly-ApoA-I诊断冠心病的曲线下面积为0.802(95%CI:0.769~0.891,P<0.001),灵敏度为82.1%,特异度为86.4%;KIM-1诊断冠心病的曲线下面积为0.795(95%CI:0.717~0.873,P<0.001),灵敏度为83.6%,特异度为80.2%,特异度为92.2%;二者联合检测诊断冠心病的曲线下面积为0.898(95%CI:0.838~0.937,P<0.001),灵敏度为94.6%。结论Gly-ApoA-I和KIM-1水平升高可能与冠心病发生风险增加有关,二者联合检测对诊断冠心病有一定价值。Objective To explore the diagnostic value and clinical significance of combined detection of glycated apolipoprotein A-I(gly-ApoA-I)and kidney injury molecule-1(KIM-1)in the coronary heart disease.Methods The plasma gly-ApoA-I and KIM-1 levels of a total of 136 patients with coronary heart disease(case group)and 50 non-coronary heart disease controls(control group)were detected,and the correlation between the two indicators and the differences between the groups were analyzed.At the same time,the case group was divided into stable angina pectoris(SAP)group,unstable angina pectoris(UAP)group and acute myocardial infarction(AMI)group,and the differences of gly-ApoA-I and KIM-1 levels between the three groups and the control group were analyzed.The receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of gly-ApoA-I and KIM-1 in the diagnosis of coronary heart disease.Results Compared with the control group,the proportion of type 2 diabetes and smoking was higher in the case group,and KIM-1 and gly-ApoA-I increased(P<0.05).Compared with the control group,the levels of gly-ApoA-I and KIM-1 in the SAP group,UAP group,and AMI group were significantly increased(P<0.05).Compared with the SAP group,the levels of gly-ApoA-I and KIM-1 in the UAP group and AMI group were significantly increased(P<0.05).Compared with the UAP group,the levels of gly-ApoA-I and KIM-1 in the AMI group were significantly higher(P<0.05).Correlation analysis showed that gly-ApoA-I was positively correlated with KIM-1 level(r=0.788,P<0.001).ROC curve analysis in diagnosing coronary heart disease showed that the area under the curve of gly-ApoA-I was 0.802(95%CI:0.769-0.891,P<0.001),and the sensitivity was 82.1%,the specificity was 86.4%.The area under the curve of KIM was 0.795(95%CI:0.717-0.873,P<0.001),and the sensitivity was 83.6%,the specificity was 80.2%.The area under the curve of the combined detection of the two indicators was 0.898(95%CI:0.838-0.937,P<0.001),and the sensitivity was 94.6%,the specificity was 92.2%.Con

关 键 词：糖基化载脂蛋白A-I 肾损伤因子-1 冠心病 诊断价值 相关性 

分 类 号：R446.1[医药卫生—诊断学]