Angptl2 YKL-40和SII水平与高血压合并不稳定型心绞痛患者相关性研究  

Correlation between Angptl2 YKL-40 and SII Levels and Patients with Hypertension Combined with Unstable Angina Pectoris

作　　者：王瑞旭 金凤表[1] 李博[1] 高宇[1] 林一鹏 卢艺心 侯瑞田[1] WANG Ruixu;JIN Fengbiao;LI Bo(The Affiliated Hospital of Chengde Medical University,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《河北医学》2023年第7期1099-1105,共7页Hebei Medicine

基　　金：河北省自然科学基金项目,(编号:C2022406011);2022年度承德市科技局基础研究项目,(编号:202205B074)。

摘　　要：目的:探讨血管紧张素样蛋白2(Angptl2)、甲壳质酶蛋白40(YKL-40)和全身免疫炎症指数(SII)水平在原发性高血压(EH)合并不稳定型心绞痛(UA)诊断中的联合应用价值,并分析其与冠状动脉病变程度的相关性。方法:收集2020年12月至2021年12月在承德医学院附属医院以EH收治入院的161例患者的临床资料。其中,根据是否合并UA分为EH组(n=76)、EH+UA组(n=85)。分别测定两组患者的血清Angptl2、YKL-40水平,根据相应公式计算得出SII水平。比较各组的一般资料以及Angptl2、YKL-40和SII水平的差异,采用多因素Logistic回归分析EH+UA的独立影响因素,Spearman秩相关分析Angptl2、YKL-40和SII水平与冠状动脉病变程度的相关性,受试者工作特征(ROC)曲线分析Angptl2、YKL-40和SII水平预测EH+UA的敏感度和特异度。结果:EH+UA组低密度脂蛋白胆固醇(LDLC)、超敏C-反应蛋白(hsCRP)、白细胞(WBC)、中性粒细胞计数(Neutrophil)、SII、Angptl2和YKL-40水平高于EH组(均P<0.05);EH+UA组淋巴细胞计数(Lymphocyte)低于EH组(P<0.05)。Angptl2、YKL-40和SII水平可能是EH+UA的独立预测因素(P<0.05)且与Angptl2、YKL-40和SII水平与Gensini积分呈正相关(P<0.05)。SII、Angptl2和YKL-40在EH+UA诊断中的ROC曲线下面积(AUC)分别为0.783、0.789和0.86,三者联合诊断的AUC大于单独SII、Angptl2和YKL-40或两两诊断的AUC(P<0.05)。结论:Angptl2、YKL-40和SII水平的异常上调可能是EH+UA的危险预测因素,高水平Angptl2、YKL-40和SII水平的还可能是评估冠状动脉病变的严重程度的预测指标,且三者联合检测对EH+UA的诊断价值更高。Objective:To investigate the diagnosis value of combined angiotensin-like protein 2(Angptl2),chitinase protein 40(YKL-40)and systemic immune inflammatory index(SII)levels for essential hypertension(EH)combined with unstable angina(UA)and to analyze their correlation with the degree of coronary artery lesions.Methods:The clinical data of 161 patients admitted with EH to the Affiliated Hospital of Chengde Medical University from December 2020 to December 2021 were collected.They were divided into EH group(n=76)and EH+UA group(n=85)according to whether they had UA.The serum Angptl2 and YKL-40 levels were measured separately in the two groups,and the SII levels were calculated according to the corresponding formula.General information and differences in Angptl2,YKL-40 and SII levels were compared between the groups.Multi-factor logistic regression was used to analyse independent influences on EH+UA,Spearman's rank correlation was used to analyse the correlation between Angptl2,YKL-40 and SII levels and the degree of coronary artery disease,and ROC curves were used to analyse the sensitivity and specificity of Angptl2,YKL-40 and SII levels in predicting EH+UA.Results:The levels of low-density lipoprotein cholesterol(LDL-C),supersensitive C-reactive protein(hsCRP),white blood cells(WBC),neutrophil count(Neutrophil),SII,Angptl2 and YKL-40 were higher in the EH+UA group than in the EH group(all P<0.05);the lymphocyte count(Lymphocyte)was lower in the EH+UA group than in the EH group(P<0.05).Angptl2,YKL-40 and SII levels may be independent predictors of EH+UA(P<0.05)and positively correlated with Angptl2,YKL-40 and SII levels and Gensini score(P<0.05).SII,Angptl2 and YKL-40 in the diagnosis of EH+UA.The area under the ROC curve(AUC)was 0.783(95%CI:0.714-0.853),0.789(95%CI:0.721-0.858)and 0.86(95%CI:0.806-0.914),respectively,and the AUC of the three combined diagnoses was greater than that of SII,Angptl2 and YKL-40 alone or both AUC,and was more sensitive.Conclusion:Abnormal up-regulation of Angptl2,YKL-40 and SII levels m

关 键 词：原发性高血压 不稳定性心绞痛 甲壳质酶蛋白40 血管紧张素样蛋白2 全身免疫炎症指数 GENSINI积分 

分 类 号：R541.4[医药卫生—心血管疾病] R544.11[医药卫生—内科学]