血清总PSA、游离PSA与老年亚临床冠状动脉粥样硬化的关系  

Relationship among serum total PSA,free PSA and elderly subclinical coronary atherosclerosis

作　　者：蔡濛 范斌[1] 汪蕾[1] Cai Meng;Fan Bin;Wang Lei(Department of Geriatric Medicine,Beijing Jishuitan Hospital,Beijing 100035,China;不详)

机构地区：[1]北京积水潭医院老年科,北京100035

出　　处：《中国循证心血管医学杂志》2022年第2期207-209,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：北京市保健科研课题项目(京17-3号)。

摘　　要：目的探讨血清总前列腺特异性抗原(PSA)、游离PSA表达与老年亚临床冠状动脉粥样硬化(SCA)的关系。方法选取2017年5月至2018年5月于北京积水潭医院老年科行冠状动脉(冠脉)造影检查的154例老年男性住院患者为研究对象,根据是否发生SCA将患者分为非SCA组(n=73)和SCA组(n=81),检测两组患者血清总PSA、游离PSA表达水平并比较;绘制受试者工作特征(ROC)曲线评估血清总PSA、游离PSA对SCA的诊断价值;采用多因素Logistic回归模型分析影响SCA发生的因素。结果两组在年龄、体质指数(BMI)、吸烟史、糖尿病史均无统计学差异(P>0.05),在收缩压、舒张压、高血压史均有统计学差异(P<0.05);SCA组与非SCA组比较,血清总PSA、游离PSA水平均升高(P<0.05);血清总PSA、游离PSA及两者联合诊断SCA的曲线下面积(AUC)由低到高依次为0.852(95%CI:0.789~0.916)、0.857(95%CI:0.800~0.914)、0.935(95%CI:0.894~0.975),总PSA、游离PSA诊断SCA的最佳临界值分别为3.76 ng/ml和2.04 ng/ml,对应敏感度分别为84.00%、67.90%,特异度分别为79.50%、90.40%。两者联合诊断SCA的敏感度为87.70%,特异度为89.20%,两者联合检测诊断SCA的敏感度最高,单独检测游离PSA诊断SCA的特异度最高。多因素Logistic回归分析结果显示,收缩压、舒张压、高血压史、总PSA、游离PSA均是影响SCA发生的危险因素(P<0.05)。结论血清总PSA、游离PSA与SCA密切相关,可为SCA提供一定预警作用。Objective To investigate the relationship among levels of serum total prostate specific antigen(PSA)and free PSA and elderly subclinical coronary atherosclerosis(SCA).Methods Male patients(n=154)undergone examination of coronary angiography(CAG)were chosen from Department of Cardiovascular Medicine in Beijing Jishuitan Hospital from May 2017 to May 2018,and divided,according to SCA occurrence,into non-SCA group(n=73)and SCA group(n=81).The levels of serum total PSA and free PSA were detected and compared in 2 groups.The diagnostic value of serum total PSA and free PSA to SCA was reviewed by using receiver operating characteristic(ROC)curve.The influence factors of SCA occurrence were analyzed by using multi-factor Logistic regression model.Results The difference in age,body mass index(BMI),smoking history and diabetes history had no statistical significance(P>0.05),which in systolic blood pressure(SBP),diastolic blood pressure(DBP)and hypertension history had statistical significance(P<0.05)between 2 groups.The levels of serum total PSA and free PSA increased in SCA group compared with non-SCA group(P<0.05).The area under curve(AUC)for diagnosing SCA of total PSA was 0.852(95%CI:0.789~0.916),AUC of free PSA was 0.857(95%CI:0.800~0.914),and AUC of total PSA combined with free PSA was 0.935(95%CI:0.894~0.975).The optimum critical value of total PSA was 3.76 ng/ml,sensitivity was 84.00%and specificity was 79.50%,and optimum critical value of free PSA was 2.04 ng/ml,sensitivity was 67.90%and specificity was 90.40%.The sensitivity of total PSA combined with free PSA was 87.70%and specificity was 89.20%.The sensitivity of total PSA combined with free PSA was the highest,and specificity of single free PSA was the highest in SCA diagnosis.The results of multi-factor Logistic regression analysis showed that SBP,DBP,hypertension history,total PSA and free PSA all were risk factor of SCA occurrence(P<0.05).Conclusion The levels of serum total PSA and free PSA are closely correlated to SCA,and they can play a role of early w

关 键 词：总前列腺特异性抗原 游离前列腺特异性抗原 老年 亚临床冠状动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病]