外周血RDW、ox-LDL、Egr3水平与CAS病变程度的关系及预测心肌梗死的价值  

Relationship of RDW,ox-LDL,Egr3 levels in peripheral blood with the degree of CAS lesions and their value in predicting myocardial infarction

作　　者：李洪光 敬仰 程栋[2] LI Hong-guang;JING Yang;CHENG Dong(Department of Cardiovascular Medicine,Henan Second People's Hospital,Zhengzhou 451191,Henan,CHINA;The Second Ward of the Cardiovascular Department,East Campus,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,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451191 [2]郑州大学第一附属医院东院区心血管内科二病区,河南郑州450000

出　　处：《海南医学》2024年第5期680-685,共6页Hainan Medical Journal

基　　金：2020年河南省医学科技攻关计划联合共建项目(编号:LHGJ20202341)。

摘　　要：目的 分析外周血红细胞体积分布宽度(RDW)、氧化低密度脂蛋白(ox-LDL)、早期生长反应因子3(Egr3)水平与冠状动脉粥样硬化(CAS)病变程度的关系,并探讨其预测急性心肌梗死(AMI)的价值。方法 选取2021年5月至2022年2月河南省第二人民医院收治的120例CAS患者作为研究组,另选取同期60例因胸痛入院但冠状动脉造影(CAG)检查结果正常的患者作为对照组。比较两组患者的一般资料、外周血RDW、ox-LDL、Egr3水平,并比较研究组不同CAS病变程度患者外周血RDW、ox-LDL、Egr3水平,采用Spearman相关系数分析外周血RDW、ox-LDL、Egr3水平与CAS病变程度的相关性。比较随访12个月内发生与未发生AMI患者入院时外周血RDW、ox-LDL、Egr3水平及心肌标志物[心肌肌钙蛋白I(cTnI)、肌酸激酶MB同工酶(CK-MB)、氨基末端脑钠肽前体(NT-proBNP)]水平,采用受试者工作特征曲线(ROC)分析RDW、ox-LDL、Egr3、心肌标志物对CAS患者发生AMI的预测价值,将RDW、ox-LDL、Egr3、心肌标志物联合预测AMI作为新预测方案,心肌标志物联合预测AMI作为常规预测方案,比较两种预测方案对AMI的预测价值。结果 研究组患者的外周血RDW、ox-LDL、Egr3水平分别为(21.65±3.79)%、(25.17±4.76)μg/L、(1 715.36±543.81) ng/L,明显高于对照组的(14.87±2.15)%、(1.35±0.43)μg/L、(1 129.48±368.25) ng/L,差异均有统计学意义(P<0.05);外周血RDW、ox-LDL、Egr3水平随着CAS病变程度的增加而逐渐升高,且差异均有统计学意义(P<0.05);经Spearman相关分析结果显示,外周血RDW、ox-LDL、Egr3水平与CAS病变程度呈正相关(P<0.05);发生AMI患者入院时外周血RDW、ox-LDL、Egr3水平、血清c Tn I、CK-MB、NT-proBNP水平明显高于未发生AMI患者,差异均有统计学意义(P<0.05);经ROC分析结果显示,入院时外周血RDW、ox-LDL、Egr3、血清cTnI、CK-MB、NT-proBNP预测CAS患者发生AMI的曲线下面积(AUC)分别为0.735、0.754、0.775、0.737、0.739�Objective To analyze the relationship of the red blood cell volume distribution width(RDW),oxidized low density lipoprotein(ox-LDL),early growth response factor 3(Egr3) levels in peripheral blood with the severity of coronary atherosclerosis(CAS),and to explore their value in predicting acute myocardial infarction(AMI).Methods A total of 120 CAS patients from Henan Second People's Hospital from May 2021 to February 2022 were selected as the study group,and another 60 patients admitted to the hospital with chest pain but normal coronary angiography(CAG) results during the same period were selected as the control group.The general data,peripheral blood RDW,ox-LDL,and Egr3 levels were compared between the two groups of patients,and the peripheral blood RDW,ox-LDL,and Egr3 levels in patients with different CAS lesion severity were compared in the study group.Spearman correlation coefficient analysis was used to analyze the correlation between the peripheral blood RDW,ox-LDL,and Egr3 levels and the severity of CAS lesions.The levels of peripheral blood RDW,ox-LDL,Egr3,and cardiac markers [cardiac troponin I(c TnI),creatine kinase MB isoenzyme(CK-MB),and N-terminal pro-brain natriuretic peptide(NT-proBNP)] were compared between patients with and without AMI during the 12-month follow-up period.The receiver operating characteristic(ROC) curve was used to analyze the predictive value of RDW,ox-LDL,Egr3,and cardiac markers for the occurrence of AMI in CAS patients.The prediction of AMI using RDW,ox-LDL,Egr3,and cardiac markers in combination was considered as a new prediction scheme,and the prediction of AMI using cardiac markers in combination was considered as a conventional prediction scheme.The predictive value of the two prediction schemes for AMI was compared.Results The levels of RDW,ox-LDL,and Egr3 in peripheral blood of the patients in the study group were(21.65±3.79)%,(25.17±4.76) μg/L,and(1 715.36±543.81) ng/L,respectively,which were significantly higher than(14.87±2.15)%,(1.35±0.43) μg/L,and(1 129.48±3

关 键 词：冠状动脉粥样硬化 红细胞体积分布宽度 氧化低密度脂蛋白 早期生长反应因子3 心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]