冠心病患者血清ox-LDL、SAA、IL-6、25(OH)D3表达及临床意义  

Serum ox-LDL,SAA,IL-6 and 25(OH)D3 levels and their clinical significance in patients with coronary heart disease

作　　者：杨光 毛婷婷 陈红蕾 张海燕[1] YANG Guang;MAO Ting-ting;CHEN Hong-lei;ZHANG Hai-yan(Laboratory Medicine,Anyang People's Hospital,Anyang,Henan 455000,China)

机构地区：[1]安阳市人民医院检验科,河南安阳455000

出　　处：《医药论坛杂志》2024年第12期1332-1337,共6页Journal of Medical Forum

摘　　要：目的探究冠心病患者血清氧化型低密度脂蛋白(ox-LDL)、淀粉样蛋白A(SAA)、白介素-6(IL-6)、25羟基维生素D3[25(OH)D3]水平及临床意义。方法选取2023年3月至2023年8月期间200例冠心病患者作为研究对象,根据SYNTAX积分将患者分为高危组、中危组、低危组,采用Rentrop法评估患者的侧支循环情况并分为侧支循环良好组、侧支循环不良组,比较不同分组患者临床指标[低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、甘油三酯(TG)]及血清ox-LDL、SAA、IL-6、25(OH)D3水平,分析血清ox-LDL、SAA、IL-6、25(OH)D3水平与临床指标的相关性,分析侧支循环不良的独立相关因素,建立预测模型,采用受试者工作特征曲线(ROC)验证模型的预测效能。结果低危组、中危组、高危组SYNTAX积分、LDL-C、TC、TG及血清ox-LDL、SAA、IL-6水平均呈升高趋势,HDL-C及血清25(OH)D3水平均呈下降趋势(P<0.05);侧支循环不良组血清ox-LDL、SAA、IL-6水平高于侧支循环良好组(P<0.05),25(OH)D3水平低于侧支循环良好组(P<0.05);Pearson相关性分析显示,血清ox-LDL、SAA、IL-6水平与SYNTAX积分、TC、TG均呈正相关(P<0.05),与Rentrop分级均呈负相关(P<0.05),ox-LDL、SAA、IL-6水平与HDL-C呈负相关(P<0.05),25(OH)D3水平与SYNTAX积分、TC、TG均呈负相关(P<0.05),与Rentrop分级、HDL-C呈正相关(P<0.05);logistic多因素回归分析显示,ox-LDL、SAA、IL-6、25(OH)D3均为冠心病患者侧支循环不良的独立相关因素(P<0.05);构建侧支循环不良的预测模型:Y=-5.525+0.054 X1+0.353 X2+0.205X3-0.091 X4,Y代表侧支循环不良的回归系数,X1~X4分别表示ox-LDL、SAA、IL-6、25(OH)D3;ROC曲线显示,该模型预测侧支循环不良的ROC曲线下面积为0.879(95%CI:0.832~0.925,P<0.001),最佳截断值对应的敏感度、特异度、约登指数分别为90.2%、69.5%、0.597,拟合优度检验显示,χ^(2)=3.955,P=0.961。结论冠心病患者血清ox-LDL、SAA、IL-Objective To explore the levels and clinical significance of serum oxidized low-density lipoprotein(ox-LDL),serum amyloid protease A(SAA),interleukin-6(IL-6)and 25-hydroxyvitamin D3[25(OH)D3]in patients with coronary heart disease.Methods Totally 200 patients with coronary heart disease from March 2023 to August 2023 were selected as study subjects,and they were divided into high-risk group,middle-risk group and low-risk group according to SYNTAX score.The collateral circulation of patients was evaluated by Rentrop method,and the patients were classified into good collateral circulation group and poor collateral circulation group.Clinical indicators[low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),total cholesterol(TC),triglyceride(TG)]and serum levels of ox-LDL,SAA,IL-6 and 25(OH)D3 were compared among different groups.The correlation between serum levels of ox-LDL,SAA,IL-6 and 25(OH)D3 and clinical indicators was analyzed,and the independent related factors of poor collateral circulation were analyzed and the prediction model was established.The predictive efficiency of the model was verified by receiver operating characteristic curve(ROC).Results The SYNTAX score and levels of LDL-C,TC,TG and serum ox-LDL,SAA and IL-6 in low-risk,middle-risk and high-risk groups were all increased while the levels of HDL-C and serum 25(OH)D3 were decreased(P<0.05).The levels of serum ox-LDL,SAA and IL-6 in poor collateral circulation group were higher than those in good collateral circulation group(P<0.05)while the level of 25(OH)D3 was lower than that in good collateral circulation group(P<0.05).Pearson correlation analysis showed that serum ox-LDL,SAA and IL-6 levels were positively correlated with SYNTAX score,TC and TG(P<0.05),and were negatively correlated with Rentrop grading(P<0.05),and ox-LDL,SAA and IL-6 levels were negatively correlated with HDL-C(P<0.05).The 25(OH)D3 level was negatively correlated with SYNTAX score,TC and TG(P<0.05),and was positively correlated with Rentrop gr

关 键 词：冠心病 氧化型低密度脂蛋白 淀粉样蛋白A 白介素-6 25羟基维生素D3 临床意义 

分 类 号：R541.4[医药卫生—心血管疾病]