冠心病患者血清RPs、RBP4、HN水平与冠状动脉病变程度的关系  

Relationship between serum RPs,RBP4,HN levels and the degree of coronary artery disease in patients with coronary heart disease

作　　者：魏亚倩 陈兴龙 张璐 WEI Ya-qian;CHEN Xing-long;ZHANG Lu(Department of Cardiovascular Medicine,Henan Second People's Hospital,Zhengzhou 451100,Henan,CHINA)

机构地区：[1]河南省第二人民医院心血管内科,河南郑州451100

出　　处：《海南医学》2023年第16期2295-2300,共6页Hainan Medical Journal

基　　金：2020年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20200233)。

摘　　要：目的探讨冠心病患者血清网织血小板(RPs)、视黄醇结合蛋白4(RBP4)、抗凋亡多肽(HN)水平与冠状动脉病变程度的关系。方法选取2020年3月至2022年6月于河南省第二人民医院心血管内科行经皮冠状动脉介入(PCI)术治疗的138例冠心病患者作为研究对象,根据入院时Gensini评分分为轻度病变组(63例)、中度病变组(48例)和重度病变组(27例),术后随访6个月,根据是否发生主要心血管不良事件(MACE)分为发生MACE组(34例)和未发生MACE组(104例)。比较轻度病变组、中度病变组、重度病变组患者(术前),发生MACE组和未发生MACE组患者(术前、术后7 d)的血清RPs、RBP4、HN水平、心肌缺血总负荷(TIB)、Gensini评分,采用Pearson分析术前患者血清RPs、RBP4、HN与TIB及Gensini评分的相关性,采用受试者工作特征曲线(ROC)分析血清RPs、RBP4、HN水平联合检测对冠心病发生MACE的预测价值,分析术前、术后7 d各指标不同水平冠心病患者发生MACE的危险度。结果轻度病变组患者的血清RPs、RBP4水平、TIB、Gensini评分<中度病变组<重度病变组,轻度病变组患者的血清HN水平>中度病变组>重度病变组,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,TIB、Gensini评分与术前血清RPs、RBP4水平呈正相关(P<0.05),与HN水平呈负相关(P<0.05);术前、术后7 d,发生MACE组患者的血清RPs、RBP4水平明显高于未发生MACE组,HN水平明显低于未发生MACE组,差异均有统计学意义(P<0.05);经ROC分析结果显示,术前、术后7 d血清RPs、RBP4、HN水平联合预测冠心病患者PCI术后发生MACE的曲线下面积(AUC)分别为0.739、0.816,最佳预测敏感度、特异度分别为82.35%、65.38%和94.12%、69.23%,高于各指标单一预测(P<0.05);经危险度分析发现,术前血清RPs、RBP4、HN高水平患者发生MACE的危险度是低水平的2.095、3.330、0.538倍(P<0.05),术后7 d血清RPs、RBP4、HN高水平患者发生MACE的危险度Objective To investigate the relationship between the levels of serum reticulum platelets(RPs),Retinol binding protein 4(RBP4),anti-apoptotic polypeptides(HN)and the severity of coronary artery disease in patients with coronary heart disease.Methods A total of 138 patients with coronary heart disease who underwent percutaneous coronary intervention(PCI)at the Department of Cardiovascular Medicine,Henan Second People's Hospital from March 2020 to June 2022 were selected as the study subjects.They were divided into a mild lesion group(63 cases),a moderate lesion group(48 cases),and a severe lesion group(27 cases)based on the Gensini score at admission.After a follow-up of 6 months,they were divided into a MACE group(34 cases)and a non-MACE group(104 cases)based on the occurrence of major cardiovascular adverse events(MACE).The serum RPs,RBP4,HN levels,total myocardial ischemic burden(TIB),and Gensini scores were compared among the mild,moderate,and severe lesion groups(before surgery),and also between the MACE group and non-MACE group(before surgery and at 7 days after surgery).Pearson analysis was used to investigate the correlation between serum RPs,RBP4,HN,TIB,and Gensini scores in preoperative patients,and the predictive value of combined detection of serum RPs,RBP4,and HN levels on the occurrence of MACE in coronary heart disease was analyzed using the receiver operating characteristic curve(ROC).The risk of MACE in coronary heart disease patients with different levels of various indicators before and 7 days after surgery was analyzed.Results The serum RPs,RBP4,TIB,and Gensini scores were increased successively in mild disease group,moderate disease group,and severe disease group,while the serum HN level were decreased successively,with statistically significant differences(P<0.05).Pearson correlation analysis showed that TIB and Gensini scores were positively correlated with preoperative serum RPs and RBP4 levels(P<0.05),and negatively correlated with HN levels(P<0.05).Before and at 7 days after surgery,the s

关 键 词：冠心病 冠状动脉病变程度 网织血小板 视黄醇结合蛋白4 抗凋亡多肽 预后 相关性 

分 类 号：R541.4[医药卫生—心血管疾病]