多种心脏标志物与冠状动脉钙化积分的关系及其诊断价值探讨

发布时间：2018-03-14 04:06

本文选题：心脏标志物　切入点：冠心病　出处：《重庆医学》2016年35期 　论文类型：期刊论文

【摘要】：目的探讨多种心脏标志物与冠状动脉钙化积分(CACS)的关系及其临床诊断价值。方法选取2013年10月至2014年4月在贵州省人民医院住院的冠心病(CHD)患者70例(疾病组)和体检健康者50例(对照组),检测其血清白细胞介素-10(IL-10)、妊娠相关血浆蛋白A(PAPP-A)、高迁移率族蛋白B1(HMGB1)、脂联素(APN)、1,25二羟基维生素D3[1,25(OH)2D3]、缺氧诱导因子-1α(HIF-1α)、白细胞介素-18(IL-18)、基质γ-羧基谷氨酸蛋白(MGP)及骨桥蛋白(OPN)9种标志物水平;使用双源CT对疾病组进行冠状动脉成像检查以计算患者CACS,并根据CACS将患者分为重度、中度、轻度患者;比较各组血清心脏标志物水平,分析其与CACS的关系,并评价其临床诊断价值。结果疾病组与对照组血清1,25(OH)2D3、HIF-1α、IL-18、MGP及OPN水平比较,差异均有统计学意义(P0.05);不同CACS患者与对照组血清IL-10、PAPP-A、1,25(OH)2D3、HIF-1α、IL-18、MGP及OPN水平比较,差异均有统计学意义(P0.05);CACS与1,25(OH)2D3呈负相关(P0.05),与HIF-1α、IL-10、MGP呈正相关(P0.05),且与1,25(OH)2D3、HIF-1α、IL-18、MGP及OPN存在明显的线性关系(P0.05);绘制受试者工作特征(ROC)曲线显示,HIF-1α、MGP、1,25(OH)2D3对CHD的诊断价值较高,其ROC曲线下面积分别为0.826、0.667和0.616,灵敏度分别为73.30%、58.80%、48.50%,特异度分别为73.50%、83.70%和95.80%,3项标志物联合检测的AUC为0.845,灵敏度和特异度分别达到90.0%和70.0%。结论多项心脏标志物对CHD具有较高的诊断价值,加强心脏标志物与动脉粥样硬化及钙化的相关性研究,有利于促进心脏标志物的临床应用。
[Abstract]:Objective to investigate the relationship between various cardiac markers and coronary artery calcification score (CACSs) and their clinical diagnostic value. Methods 70 patients with coronary heart disease (CACS) hospitalized in Guizhou Provincial people's Hospital from October 2013 to April 2014 (disease group) were selected. And 50 healthy controls (control group), serum interleukin-10 (IL-10), pregnancy-associated plasma protein (PAPP-An), high mobility group protein B1 (HMGB1), adiponectin (APNX) 25 dihydroxyvitamin D3, hypoxia inducible factor-1 伪 (HIF-1 伪), interleukin-18 (IL-18), matrix 纬 -carboxylic acid (纬 -carboxylic group). The levels of 9 markers of glutamate protein (MGP) and osteopontin (OPN); Coronary angiography was performed in the disease group with dual-source CT, and the patients were divided into severe, moderate and mild patients according to CACS. The serum cardiac markers in each group were compared, and the relationship between CACS and CACS was analyzed. Results the serum levels of IL-18 MGP and OPN in patients with different CACS and control group were significantly higher than those in control group, and the levels of IL-18 and OPN in patients with different CACS and control group were significantly higher than those in control group, and the serum levels of IL-18MGP and OPN in patients with different CACS were significantly higher than those in control group (P < 0.05), and the levels of IL-18MGP and OPN in patients with different CACS were significantly higher than those in control group (P < 0.05). The levels of IL-18MGP and OPN in serum of patients with different CACS were compared with those of control group (P < 0.05). The difference was statistically significant (P 0.05). There was a negative correlation between CACS and OH2D3 and a positive correlation with HIF-1 伪 -IL-10MGP. There was also a significant linear relationship between CACS and OPN. The diagnostic value of OHIF-1 伪 MGP-1 伪 MGP1OH2D3 was higher than that of OH2D3, and the diagnostic value of OH2D3 was higher than that of OH2D3 in diagnosis of OH2D3, the diagnostic value of OH2D3 was higher than that of OH2D3 in diagnosis of OH2D3, the diagnostic value of HIF-1 伪 was higher than that of OH2D3 in the diagnosis of OH2D3, and there was a significant linear relationship between CACS and OH2D3 in the diagnosis of CHD. The area under the ROC curve was 0.826, 0.667 and 0.616, the sensitivity was 73.30 and 58.80,48.50, and the specificity was 73.500.83.70% and 95.800.450.The sensitivity and specificity of the three markers were 90.0% and 70.00.Conclusion many cardiac markers have high diagnostic value for CHD. Strengthening the relationship between cardiac markers and atherosclerosis and calcification is helpful to promote the clinical application of cardiac markers.
【作者单位】：贵州省人民医院临床检验中心;贵航集团303医院检验科;贵州省人民医院心内科;贵州省人民医院放射科;
【基金】：贵州省省长资金临床应用课题专项研究项目[黔省专合字(2012)117号]
【分类号】：R541.4;R446.1

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