冠心病患者血清Wnt-1、DKK-1水平及红细胞分布宽度的改变及其意义  

Changes and their significance of serum levels of Wnt-1,DKK-1 and red cell distribution width in patients with coronary heart disease

作　　者：刘彤彤 林全强 董莎莎 徐秀秀 张晨 赵健 LIU Tongtong;LIN Quanqiang;DONG Shasha;XU Xiuxiu;ZHANG Chen;ZHAO Jian(Department of Cardiology,the Second Affiliated Hospital of Shandong First Medical University,Taian Shandong 271000,China)

机构地区：[1]山东第一医科大学第二附属医院心内科,山东泰安271000

出　　处：《实用心电学杂志》2023年第2期96-101,共6页Journal of Practical Electrocardiology

基　　金：山东省中医药科技项目(2021M187)。

摘　　要：目的探讨Wnt-1、Dickkopf相关蛋白1(DKK-1)、红细胞分布宽度(red cell distribution width,RDW)与冠心病的相关性,并分析Wnt-1、DKK-1和RDW之间的内在联系及其对冠心病的联合诊断价值。方法选取行冠状动脉(简称冠脉)造影的住院患者188例,根据冠脉造影结果将其分为冠心病组(n=128)和非冠心病组(n=60)并收集临床资料,比较两组间的Wnt-1、DKK-1、RDW差异。结果冠心病组患者血清Wnt-1水平降低,而DKK-1、RDW升高,与非冠心病组相比差异均有统计学意义(P<0.05);冠心病组中的急性心肌梗死组(30例)、不稳定型心绞痛组(54例)和稳定型心绞痛组(44例)三个亚组间Wnt-1、DKK-1及RDW差异均无统计学意义(P>0.05)。经Logistic回归分析,Wnt-1、DKK-1、RDW的OR值分别为0.947、1.023、64.995。三者联合诊断冠心病的受试者工作特征曲线下面积为0.977(95%CI 0.958~0.997),敏感性为92.2%,特异性为96.7%。结论DKK-1、RDW可能为发生冠心病的独立危险因素,Wnt-1可能为发生冠心病的独立保护因素。Wnt-1、DKK-1、RDW三者联合高于上述任一指标单独对冠心病的诊断价值。Objective To explore the correlation between Wnt-1,Dickkopf-associated protein 1(DKK-1),red cell distribution width(RDW)and coronary heart disease(CHD).To analyze the inherent relationship among Wnt-1,DKK-1 and RDW,and their joint diagnostic value on CHD.Methods We selected 188 inpatients who had undergone coronary angiography(CAG).They were divided into CHD group(n=128)and non-CHD group(n=60)according to CAG results.The clinical data were collected,and the levels of Wnt-1,DKK-1 and RDW were compared between the two groups.Results In the CHD group,the serum level of Wnt-1 decreases while the levels of DKK-1 and RDW increase.There are statistically significant differences of the above indexes between the two groups(P<0.05).The levels of Wnt-1,DKK-1 and RDW do not vary significantly among the three subgroups of the CHD group,that is,acute myocardial infarction group(30 cases),unstable angina pectoris group(54 cases)and stable angina pectoris group(44 cases)(P>0.05).Logistic regression analysis reveals that OR values of Wnt-1,DKK-1 and RDW are separately 0.947,1.023 and 64.995.In the joint diagnosis of CHD,the area under the receiver operating characteristic curve of the three indexes is 0.977(95%CI 0.958-0.997),with a sensitivity of 92.2%and a specificity of 96.7%.Conclusion DKK-1 and RDW may be independent risk factors for CHD;Wnt-1 is probably its independent protective factor.The joint diagnostic value of Wnt-1,DKK-1 and RDW for CHD is higher than that of any of the above indexes alone.

关 键 词：冠心病 WNT-1 DKK-1 红细胞分布宽度 

分 类 号：R541.4[医药卫生—心血管疾病]