冠心病患者血清指标水平变化及其与疾病进展的关系研究  

Study on the changes of serum index levels in patients with coronary heart disease and their relationship with disease progression

作　　者：石文界 张慧娜[1] 哈斯达尔·米地里别克 刘成[1] SHI Wen-jie;ZHANG Hui-na;HASIDAER Midilibieke;LIU Cheng(Department of Cardiology,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院心脏中心,新疆维吾尔自治区乌鲁木齐市830054

出　　处：《中国心血管病研究》2024年第7期612-616,共5页Chinese Journal of Cardiovascular Research

基　　金：新疆早发冠心病新的遗传变异位点的筛查及分子机制研究(编号:2022B03022-4)。

摘　　要：目的探讨冠心病患者血清脂蛋白磷脂酶A2(Lp-PLA2)、CX3C趋化因子配体1(CX3CL1)和成纤维细胞生长因子-23(FGF23)表达及其与疾病进展的关系。方法选择2021年9月~2023年9月新疆医科大学第一附属医院收治的324例冠心病患者作为病例组,根据疾病进展程度将其分为轻度组(76例)、中度组(145例)和重度组(103例),另选同期于本院进行体检的380名健康人群作为对照组。比较病例组和对照组基本资料及血清Lp-PLA2、CX3CL1、FGF23水平,对比不同疾病进展程度冠心病患者血清Lp-PLA2、CX3CL1、FGF23水平,多因素logistic回归分析冠心病患者发病的危险因素,受试者工作特征曲线(ROC)分析血清Lp-PLA2、CX3CL1、FGF23单一及联合检测对冠心病的诊断价值。结果病例组有吸烟史、合并糖尿病、高血压患者比例及血清Lp-PLA2、CX3CL1、FGF23水平高于对照组(P<0.05)。重度组血清Lp-PLA2、CX3CL1、FGF23水平高于中度组和轻度组(P<0.05),中度组高于轻度组(P<0.05)。多因素logistic回归分析结果显示,有吸烟史(OR=2.408)、合并糖尿病(OR=2.497)、合并高血压(OR=2.221)、血清Lp-PLA2水平偏高(OR=3.083)、血清CX3CL1水平偏高(OR=2.992)、血清FGF23水平偏高(OR=3.142)是冠心病患者发病的危险因素(P<0.05)。ROC曲线分析结果显示,血清Lp-PLA2、CX3CL1、FGF23联合检测诊断冠心病的曲线下面积(AUC)值为0.917,高于三者单一检测(0.768、0.807、0.872,P<0.05)。结论冠心病患者血清Lp-PLA2、CX3CL1、FGF23水平呈高表达,三者可参与患者疾病进展过程,且三者联合检测对冠心病诊的断价值更高。Objective To investigate the expression of serum lipoprotein phospholipase A2(Lp-PLA2),CX3C chemokine ligand 1(CX3CL1)and fibroblast growth factor-23(FGF23)and their relationship with disease progression in patients with coronary artery disease.Methods A total of 324 patients with coronary artery disease admitted to the First Affiliated Hospital of Xinjiang Medical University from September 2021 to September 2023 were selected as the case group,and they were divided into the mild(76 cases),moderate(145 cases)and severe(103 cases)groups according to the degree of disease progression;meanwhile,380 healthy people who underwent physical examination in the same hospital were selected as the control group.The basic data and serum Lp-PLA2,CX3CL1 and FGF23 levels between the case group and the control group were compared,and the serum Lp-PLA2,CX3CL1 and FGF23 levels in patients with coronary artery disease with different degrees of disease progression were compared;multifactorial logistic regression was used to analyze the risk factors for the onset of coronary artery disease in patients with coronary artery disease,and the receiver operating characteristic curve(ROC)was used to analyze the value of the serum Lp-PLA2,CX3CL1 and FGF23 levels single and combined tests for the diagnosis of coronary heart disease.Results The proportion of patients with smoking history,combined diabetes and hypertension and serum Lp-PLA2,CX3CL1 and FGF23 levels were higher in the case group than in the control group(P<0.05).The serum Lp-PLA2,CX3CL1 and FGF23 levels were higher in the severe group than in the moderate and mild groups(P<0.05);and higher in the moderate group than in the mild group(P<0.05).The results of multifactorial logistic regression analysis showed that a history of smoking(OR=2.408),combined diabetes mellitus(OR=2.497),combined hypertension(OR=2.221),high serum Lp-PLA2 level(OR=3.083),high serum CX3CL1 level(OR=2.992),and high serum FGF23 level(OR=3.142)were all the risk factors for the development of coronary artery dise

关 键 词：冠心病 脂蛋白磷脂酶A2 CX3C趋化因子配体1 成纤维细胞生长因子-23 疾病进展 诊断价值 

分 类 号：R541.4[医药卫生—心血管疾病]