稳定型心绞痛患者血浆中性粒细胞明胶酶脂质运载蛋白与冠状动脉斑块结构的相关性研究  

Correlation between neutrophil gelatinase lipid carrier protein and coronary plaque structure in patients with stable angina pectoris

作　　者：刘成峰 宇文雅 邢坤[1] 叶晨 杨禹娟[1] LIU Cheng-feng;YU Wen-ya;XING Kun;YE Chen;YANG Yu-juan(Three Departments of Cardiovascular Surgery at the Elderly Hospital of Shaanxi Provincial People’s Hospital,Xian 710000,China)

机构地区：[1]陕西省人民医院老年病院心血管内三科,陕西省西安市710000

出　　处：《中国心血管病研究》2023年第12期1074-1079,共6页Chinese Journal of Cardiovascular Research

基　　金：陕西省人民医院科技人才支持计划项目(2021JY-28);陕西省分子心脏病学重点实验室开放课题(KLMC-2018-04);陕西省人民医院科技发展孵化基金项目(2022YJY-51)。

摘　　要：目的分析稳定型心绞痛(SAP)患者血浆中性粒细胞明胶酶脂质运载蛋白(NGAL)水平与冠状动脉粥样硬化斑块结构指标,探讨血浆NGAL水平与SAP患者冠状动脉粥样斑块结构相关性。方法收集2021年11月至2022年6月于陕西省人民医院确诊SAP的患者,根据入组及排除标准,共入组患者72例,收集患者的临床资料和实验室检查资料,以及冠状动脉血管内超声(IVUS)数据。对比分析SAP患者的血浆NGAL水平与冠状动脉斑块结构的相关性。结果相关性分析显示,血浆NGAL水平在一定范围内与冠状动脉粥样斑块的纤维帽厚度成反比(r=-0.563,P<0.01),与斑块负荷成正比(r=0.328,P<0.01),差异有统计学意义。根据入组试验患者斑块纤维帽厚度数据分布特征,按M=0.4583 mm将分为薄纤维帽组和厚纤维帽组,logistic回归分析显示,血浆NGAL水平是粥样斑块纤维帽厚度的影响因素(OR=4,95%CI 1.501~10.658,P<0.01)。以冠状动脉粥样斑块负荷70%为界值,将纳入研究患者分为低斑块负荷组和高斑块负荷组。Logistic回归分析显示,血浆NGAL水平是冠状动脉粥样斑块斑块负荷(OR=7.800,95%CI 2.731~22.274,P<0.01)的影响因素。结论稳定型心绞痛患者血浆NGAL水平与冠状动脉粥样斑块的结构特征具有显著的相关性:NGAL越高,动脉粥样斑块纤维帽越薄,斑块负荷越大。NGAL是冠状动脉粥样斑块负荷及斑块纤维帽厚度的影响因素。Objective To explore the correlation between the plasma neutrophil gelatinase lipid carrier protein(NGAL)leveland the structure of coronary atherosclerotic plaque in the patients with stable angina pectoris(SAP).Method 72 patients who were diagnosed with stable angina pectoris in Shanxi Provincial People’s Hospital from November 2021 to June 2022were enrolled according to the inclusion and exclusion criteria,The clinical data and laboratory examination data of the patients were collected,as well as the intravascular ultrasound(IVUS)examination of the coronary artery.The correlation of plasma NGAL level with the structural indicators of coronary plaque was analyzed.Results Correlation analysis showed that the plasma NGAL level was inversely proportional to the fiber cap thickness of coronary atherosclerotic plaque within a certain range(r=-0.563,P<0.01)and directly proportional to the plaque burden(r=0.328,P<0.01),which had a significant difference.According to the distribution characteristics of plaque fiber cap thickness data,the people was divided into the thin fiber cap group and the thick fiber cap group in the light of M=0.4583 mm.Logistic regression analysis showed that the NGAL level was the influencing factor of plaque fiber cap thickness(OR=4,95%CI 1.501-10.658,P<0.01).The patients were divided into the low plaque load group and high plaque load group with 70%of coronary atherosclerotic plaque load as the threshold and then.Logistic regression analysis showed that the plasma NGAL level was the influencing factor of coronary atherosclerotic plaque load(OR=7.800,95%CI 2.731-22.274,P<0.01).Conclusion There is a significant correlation between the plasma NGAL level and the coronary atherosclerotic plaque in patients with stable angina pectoris:the NGAL level higher,the fibrous cap of atherosclerotic thinner and the plaque load bigger.The plasma NGAL is the influencing factor of the structural characteristics of coronary atherosclerotic plaque.

关 键 词：稳定型心绞痛 血浆中性粒细胞明胶酶脂质运载蛋白 冠状动脉粥样斑块 

分 类 号：R541.4[医药卫生—心血管疾病]