联合检测N/OFQ、ApoA1、hs-CRP对冠心病并发SMI的预测价值  

Predictive value of joint detection of N/OFQ,ApoA1 and hs⁃CRP for SMI in coronary heart disease

作　　者：兰婷[1] 刘兴军[1] 刘国斌 刘峰 赵增 肖波 蒋川 陈丹丹 LAN Ting;LIU Xingjun;LIU Guobin;LIU Feng;ZHAO Zeng;XIAO Bo;JIANG Chuan;CHEN Dandan(Department of Cardiovascular Medicine,Jintang First People's Hospital,Chengdu,Sichuan,China,610400)

机构地区：[1]金堂县第一人民医院心血管内科,四川成都610400

出　　处：《分子诊断与治疗杂志》2024年第4期630-633,638,共5页Journal of Molecular Diagnostics and Therapy

基　　金：四川省卫生健康委员会项目(22PJ061)。

摘　　要：目的探讨联合检测内源性孤啡肽(N/OFQ)、载脂蛋白A1(ApoA1)、超敏C反应蛋白(hs-CRP)对冠心病(CHD)并发无症状心肌缺血(SMI)的预测价值。方法选取2020年5月2022年12月金堂县第一人民医院心血管内科收治的156例冠心病患者,依据是否并发SMI分为并发SMI组(n=65)及无SMI组(n=91),分析影响CHD患者并发SMI的独立危险因素,评估联合检测N/OFQ、ApoA1、hs-CRP对并发SMI的预测价值,并比较不同SMI分型患者血清N/OFQ、ApoA1、hs-CRP水平。结果两组N/OFQ、ApoA1、hs-CRP、HDL-C、LDL-C比较差异有统计学意义(P<0.05);N/OFQ>6.43 ng/L、ApoA1>120.58 mg/dL、hs-CRP>14.95 mg/L、LDL-C>5.07 mmol/L是CHD患者并发SMI的独立危险因素(P<0.05),而HDL-C>2.96 mmol/L是保护因素(P<0.05);以N/OFQ、ApoA1、hs-CRP构建的CHD并发SMI风险预测模型预测敏感度、特异度、AUC分别为80.00%、83.52%、0.850;心绞痛型、无症状型SMI患者血清N/OFQ、ApoA1、hs-CRP水平均显著低于心肌梗死型SMI患者,差异有统计学意义(P<0.05)。结论血清N/OFQ、ApoA1、hs-CRP水平的监测不仅可对CHD并发SMI早期进行预测,还可为心肌缺血疾病进展评估提供有效依据。Objective To explore the predictive value of joint detection of endogenous nociceptin(N/OFQ),apolipoprotein A1(ApoA1)and hypersensitive C⁃reactive protein(hs⁃CRP)for silent myocardial ischemia(SMI)in coronary heart disease(CHD).Methods A total of 156 patients with coronary heart dis⁃ease who were admitted to the Department of Cardiovascular Medicine at Jintang First Peoples Hospital from May 2020 to December 2022 were selected.They were divided into two groups based on the presence or absence of SMI:the SMI group(n=65)and the non⁃SMI group(n=91).The study aimed to analyze the independent risk factors for SMI in patients with CHD and evaluate the predictive value of joint detection of N/OFQ,ApoA1 and hs⁃CRP for SMI.Additionally,serum levels of N/OFQ,ApoA1 and hs⁃CRP in patients with different types of SMI were compared.Results There were statistically significant differences in N/OFQ,ApoA1,hs⁃CRP,HDL⁃C and LDL⁃C between the two groups(P<0.05).N/OFQ>6.43 ng/L,ApoA1>120.58 mg/dL,hs⁃CRP>14.95 mg/L,and LDL⁃C>5.07 mmol/L were independent risk factors for SMI in patients with CHD(P<0.05),while HDL⁃C>2.96 mmol/L was a protective factor(P<0.05).The sensitivity,specificity and AUC of the pre⁃diction model constructed based on N/OFQ,ApoA1 and hs⁃CRP for predicting SMI were 80.00%,83.52%and 0.850.Serum N/OFQ,ApoA1 and hs⁃CRP levels in patients with angina pectoris type and asymptomatic SMI were significantly lower than those in patients with myocardial infarction type SMI(P<0.05).Conclusion Monitoring serum levels of N/OFQ,ApoA1 and hs⁃CRP can not only help predict early SMI in CHD,but also provide an effective basis for evaluating the progression of myocardial ischemia.

关 键 词：内源性孤啡肽 载脂蛋白A1 超敏C反应蛋白 冠心病 无症状心肌缺血 

分 类 号：R541.4[医药卫生—心血管疾病]