血清ATF6、CaMKⅡ表达水平与冠心病及冠状动脉狭窄程度的相关性  

Correlation of serum ATF6 and CaMKⅡexpression levels with coronary heart disease and degree of coronary artery stenosis

作　　者：李金龙 张先林 路桥 徐文慧 李妙男 康品方 LI Jinlong;ZHANG Xianlin;LU Qiao;XU Wenhui;LI Miaonan;KANG Pinfang(Department of Cardiovascular Medicine,the First Affiliated Hospital of Bengbu Medical University,Bengbu Anhui 233000,China)

机构地区：[1]蚌埠医科大学第一附属医院心血管内科,安徽蚌埠233000

出　　处：《实用心电学杂志》2024年第3期237-242,249,共7页Journal of Practical Electrocardiology

基　　金：安徽省高校人文社会科学研究重点项目(2022AH051462);安徽省临床医学转化专项(202304295107020086)。

摘　　要：目的探讨激活转录因子6(activated transcription factor 6,ATF6)、钙离子/钙调蛋白依赖性蛋白激酶Ⅱ(calcium/calmodulin-dependent protein kinaseⅡ,CaMKⅡ)水平与冠心病及冠状动脉(简称冠脉)狭窄程度的相关性,并研究其对冠心病的预测价值。方法选取接受冠脉造影的265例冠心病患者,并收集其临床资料。根据冠脉造影结果及Gensini评分的中位数(38分),将这些患者分为轻度狭窄组(Gensini评分≤38分,n=105)、中重度狭窄组(Gensini评分>38分,n=100),冠脉造影结果正常者设为对照组(n=60)。观察各组患者的ATF6、CaMKⅡ表达水平并进行统计学分析。结果与对照组相比,轻度狭窄组及中重度狭窄组血清ATF6、CaMKⅡ水平均明显升高,且其水平随着冠脉狭窄程度的加重而上升,差异有统计学意义(P<0.05)。根据Logistic回归分析显示,ATF6、CaMKⅡ可能是冠心病发生的独立危险因素。ROC曲线分析显示,血清ATF6、CaMKⅡ联合预测冠心病的AUC值为0.749(95%CI 0.676~0.822),敏感性为0.663,特异性为0.717,较ATF6、CaMKⅡ单独诊断的价值更高。结论血清ATF6、CaMKⅡ水平与冠脉狭窄程度呈正相关,且ATF6、CaMKⅡ水平对冠心病具有一定的预测价值,有望为诊断冠心病及评估其严重程度提供更多的参考。Objective To investigate the relativity between levels of activated transcription factor 6(ATF6)or calcium/calmodulin-dependent protein kinaseⅡ(CaMKⅡ),and coronary heart disease(CHD)and the degree of coronary artery stenosis.To study their predictive value on CHD.Methods We selected 265 patients with CHD who had undergone coronary angiography,and collected their clinical data.According to the coronary angiographic results and the median of Gensini Score(38 points),these patients were divided into mild stenosis group(Gensini Score≤38 points,n=105),moderate and severe stenosis group(Gensini Score>38 points,n=100);those with normal coronary angiographic results were enrolled into control group(n=60).The expression levels of ATF6 and CaMKⅡwere observed and statistically analyzed among the three groups.Results Compared with the control group,the levels of serum ATF6 and CaMKⅡin the mild stenosis group,and moderate and severe stenosis group were both significantly higher;the levels increased with the increasing degree of coronary artery stenosis,with statistically significant differences(P<0.05).According to Logistic regression analysis,ATF6 and CaMKⅡmay be independent risk factors for coronary heart disease.ROC curve analysis showed that the AUC value of the combination of serum ATF6 and CaMKⅡin predicting CHD was 0.749(95%CI 0.6760.822),with a sensitivity of 0.663 and a specificity of 0.717.Its diagnostic efficiency was higher than that of either of ATF6 or CaMKⅡalone.Conclusion The levels of serum ATF6 and CaMKⅡare positively correlated with the degree of coronary artery stenosis.The levels of ATF6 and CaMKⅡhave predictive value for CHD,which are expected to provide more references for diagnosing CHD and evaluating its severity.

关 键 词：冠状动脉粥样硬化性心脏病 激活转录因子6 CaMKⅡ GENSINI评分 

分 类 号：R541.4[医药卫生—心血管疾病]