冠心病患者半乳糖凝集素-3与冠脉病变程度及预后的相关性研究

发布时间：2018-08-18 16:28

【摘要】：目的：通过检测冠心病患者血清半乳糖凝集素-3(Galectin-3)水平,分析其在不同类型冠心病患者中的水平及分别与Gensini积分、B型脑钠肽(BNP)的相关性,并观察其与冠心病患者主要心血管事件(MACE)发生的关系,初步探讨冠心病患者血清Galectin-3水平与冠状动脉病变程度及预后关系。方法：收集我院自2013年7月至2014年3月因胸痛于我科住院诊治,根据临床表现、心电图、心肌酶或冠状动脉造影(CAG)结果确诊为冠心病(CAD)的患者。从上述CAD患者中随机选取40例稳定性心绞痛(SA)患者作为A组,40例不稳定性心绞痛(UA)患者作为B组,40例急性心肌梗死(AMI)患者作为C组,共120例。收集我院体检中心行健康查体的40位健康者作为正常对照组(D组)。应用酶联免疫吸附法(ELISA)检测所有研究对象的血清Galectin-3水平,化学发光法检测BNP水平。冠脉狭窄程度采用用Gensini积分系统进行估测。对120例CAD患者进行1年的随访,记录随访期间发生的MACE。结果：1.CAD患者血清Galectin-3水平高于正常对照组,且C组患者血清Galectin-3水平高于B组,B组患者血清Galectin-3水平高于A组,除B组与C组患者血清Galectin-3水平无统计学差异(p=0.197)外,其它各组间均有统计学显著性差异(p0.01)。2.Spearman相关分析表明,Galectin-3与Gensini评分、BNP呈正相关。3.随访1年,15例患者出现MACE。与无不良心血管事件组相比,有心血管不良事件组患者血清Galectin-3水平显著升高,统计学有显著性差异(p0.05)4.多因素Logistic回归分析表明,冠心病患者血清Galectin-3 (OR=1.157, CI:1.047-1.279,p0.01)、BNP(OR=1.010,CI: 1.000-1.034,p0.028)水平与其不良预后呈正相关。结论：1.冠心病患者血清Galectin-3水平可能与AS的形成斑块不稳定性相关。2.冠心病患者血清Galectin-3水平与冠状动脉病变严重程度呈正相关。3.Galectin-3可能促进冠状动脉粥样硬化的发生、发展及心室重塑。4.血清Galectin-3水平高的CAD患者可能预后不良。
[Abstract]:Objective: to detect the level of serum galactose agglutinin 3 (Galectin-3) in patients with coronary heart disease (CHD) and its correlation with Gensini integral type B brain natriuretic peptide (BNP). The relationship between serum Galectin-3 level and the severity and prognosis of coronary artery disease (CHD) was investigated by observing the relationship between serum Galectin-3 level and the occurrence of main cardiovascular events (MACE) in patients with coronary heart disease (CHD). Methods: from July 2013 to March 2014, patients with coronary heart disease (CAD) were diagnosed as coronary heart disease (CHD) according to clinical manifestation, electrocardiogram (ECG), myocardial enzyme or coronary angiography (CAG). Forty patients with stable angina pectoris (SA) were randomly selected as group A and 40 patients with unstable angina pectoris (UA) as group B and 40 patients with acute myocardial infarction (AMI) as group C. A total of 40 healthy subjects were collected from our physical examination center as the normal control group (group D). Enzyme linked immunosorbent assay (ELISA) was used to detect the level of serum Galectin-3 and chemiluminescence to detect the level of BNP. The degree of coronary stenosis was estimated by Gensini integral system. 120 patients with CAD were followed up for 1 year. Results 1. The level of serum Galectin-3 in patients with CAD was higher than that in normal controls, and the level of serum Galectin-3 in group C was higher than that in group B (P < 0. 197). The level of serum Galectin-3 in group B was higher than that in group A (P < 0. 197). 2. Spearman correlation analysis showed that Galectin-3 was positively correlated with Gensini score. 15 patients were followed up for 1 year. Compared with the non-adverse cardiovascular events group, the serum Galectin-3 level of the patients with cardiovascular adverse events was significantly higher than that of the non-adverse cardiovascular events group (p0.05) 4. Multivariate Logistic regression analysis showed that the level of serum Galectin-3 (OR 1.157, CI: 1.047-1.279 / p0.01) was positively correlated with the poor prognosis in patients with coronary heart disease (OR 1.010 CI: 1.000-1.034 P 0.028). Conclusion 1. The serum Galectin-3 level in patients with coronary heart disease may be related to plaque instability. 2. 2. The level of serum Galectin-3 was positively correlated with the severity of coronary artery disease. 3. Galectin-3 may promote the occurrence, development and ventricular remodeling of coronary atherosclerosis. CAD patients with high serum Galectin-3 level may have poor prognosis.
【学位授予单位】：滨州医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.4

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