冠状动脉粥样硬化性心脏病患者的血清半乳糖凝集素3、生长分化因子15、降钙素原水平及其临床意义  

Serum levels of galectin 3,growth differentiation factor 15,and procalcitonin and their clinical value in patients with coronary atherosclerotic heart disease

作　　者：周耀辉[1] 胡孜阳 严宪才[1] ZHOU Yao-hui;HU Zi-yang;YAN Xian-cai(Department of Emergency,Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528400,China)

机构地区：[1]广东省中山市中医院急诊科,中山市528400

出　　处：《广西医学》2022年第3期274-278,共5页Guangxi Medical Journal

基　　金：广东省中山市社会公益科技研究项目(2019B1061)。

摘　　要：目的分析冠状动脉粥样硬化性心脏病(冠心病)患者血清半乳糖凝集素3(Gal-3)、生长分化因子15(GDF-15)、降钙素原的水平,并探讨三者的临床意义。方法选取130例冠心病患者作为研究对象,其中稳定型心绞痛(SAP)患者55例、急性冠脉综合征(ACS)患者75例,单支病变46例、双支病变52例、多支病变32例,并选取健康体检者260例作为对照组。比较两组研究对象的一般资料,以及血清Gal-3、GDF-15、降钙素原水平。采用Logistic回归模型分析与冠心病相关的因素。采用受试者工作特征(ROC)曲线分析血清Gal-3、GDF-15、降钙素原水平鉴别诊断ACS和SAP,以及诊断多支病变的效能。结果观察组高血压者比例、吸烟者比例、饮酒者比例、收缩压,以及血清总胆固醇、三酰甘油、Gal-3、GDF-15、降钙素原水平均高于对照组(均P<0.05)。ACS患者血清Gal-3、GDF-15、降钙素原水平高于SAP患者,多支病变患者血清Gal-3、GDF-15、降钙素原水平高于单支和双支病变患者(均P<0.05)。Logistic回归分析结果显示高血压、吸烟以及血清总胆固醇、Gal-3、GDF-15水平升高与冠心病相关(均P<0.05)。血清Gal-3、GDF-15、降钙素原水平对鉴别诊断ACS和SAP,以及诊断多支病变均有一定的效能,且三者联合诊断时的ROC曲线下面积及灵敏性、特异性大于或高于三者单独诊断。结论冠心病患者血清Gal-3、GDF-15、降钙素原水平升高,其中Gal-3、GDF-15与冠心病的发生密切相关,而三者均有助于评估冠心病的疾病类型和血管病变数量,且三者联合应用时评估效能提高。Objective To analyze the serum levels of galectin 3(Gal-3),growth differentiation factor 15(GDF-15),and procalcitonin in patients with coronary atherosclerotic heart disease(CHD),and to investigate the clinical significance of these three indices.Methods A total of 130 CHD patients were selected as research subjects,including 55 patients with stable angina pectoris(SAP)and 75 patients with acute coronary syndrome(ACS).Among them,there were 46 cases of single-vessel lesion,52 cases of two-vessel lesions and 32 cases of multiple-vessel lesions.Besides,260 healthy check-up individuals served as control group.The general data and the serum levels of Gal-3,GDF-15,and procalcitonin of the subjects were compared between the two groups.The Logistic regression model was used to analyze the CHD-related factors.The receiver operating characteristic(ROC)curve was used to analyze the efficiency of serum levels of Gal-3,GDF-15,and procalcitonin for differentiating ACS from SAP as well as for diagnosing multiple-vessel lesions.Results The observation group exhibited higher proportions of hypertension cases,smokers,and drinking cases,higher systolic blood pressure,and higher serum levels of total cholesterol,triacylglycerol,Gal-3,GDF-15,and procalcitonin as compared with the control group(all P<0.05).ACS patients yielded higher serum levels of Gal-3,GDF-15,and procalcitonin than SAP patients,and patients with multiple-vessel lesions exhibited higher serum levels of Gal-3,GDF-15,and procalcitonin than patients with single-or two-vessel lesions(all P<0.05).The results of Logistic regression analysis showed that hypertension,smoking,and increases in serum levels of total cholesterol,Gal-3,and GDF-15 correlated with CHD(all P<0.05).Serum levels of Gal-3,GDF-15,and procalcitonin had certain diagnostic efficacy for differentiating ACS from SAP as well as for diagnosing multiple-vessel lesions;moreover,the combination of the three indices yielded a larger area under the ROC curve and higher sensitivity and specificity than the single i

关 键 词：冠状动脉粥样硬化性心脏病 半乳糖凝集素3 生长分化因子15 降钙素原 影响因素 疾病类型 病变数量 诊断效能 

分 类 号：R543.3[医药卫生—心血管疾病]