羧化不全骨钙素与冠心病类型及其病变程度的相关性研究

发布时间：2018-09-12 05:03

【摘要】：目的：探讨血清羧化不全骨钙素水平与冠心病的类型、冠状动脉病变程度的关系,以及血清羧化不全骨钙素水平是否是冠心病的独立危险因素。方法：选择行冠状动脉造影的180例患者作为研究对象。收集患者病史资料,一般资料包括：年龄、性别、糖尿病史、高血压史、吸烟史、饮酒史。实验室资料包括：血清羧化不全骨钙素、血脂、血糖等。临床指标：收缩压、舒张压、冠状动脉造影及超声心动图。根据冠状动脉造影结果分为：冠心病组140例和正常对照组40例。比较上述两组间临床指标的差别。根据冠心病类型将冠心病组分为：急性心肌梗死(AMI)、不稳定型心绞痛(UAP)、稳定型心绞痛(SAP)三个组。同时根据病变血管支数分为单支和多支病变两个组,分别比较各组间血清羧化不全骨钙素水平。根据Gensini积分探讨血清羧化不全骨钙素与冠状动脉病变程度的相关性。对冠心病组进行多元Logistic回归分析,探讨血清羧化不全骨钙素是否是冠心病的独立危险因素。结果：1.血清羧化不全骨钙素水平在冠心病组明显低于非冠心病组[(1.02±0.35)ng/ml vs (1.32±0.51)ng/ml],差异具有统计学意义(P0.05)。2.血清羧化不全骨钙素水平在SAP组、UAP组、AMI组分别为(1.22±0.38)ng/ml、(1.04±0.23)ng/ml、(0.89±0.21)ng/ml。血清羧化不全骨钙素水平在三组间均明显低于非冠心病组(1.32±0.51) ng/ml,差异具有统计学意义(P0.05)。3.血清羧化不全骨钙素水平在正常对照组、单只、多支病变组分别为(1.32±0.51)ng/ml、(1.10±0.36)ng/ml、 (0.97±0.34) ng/ml o随着冠脉病变支数的增加,三组间比较,血清羧化不全骨钙素水平明显降低。多支病变组血清羧化不全骨钙素水平明显低于单支病变组,差异具有统计学意义(P0.05)。4.血清羧化不全骨钙素水平在Gensini高积分组与Gensini低积分组分别为(0.96±0.32)ng/ml、(1.12±0.34)ng/ml,两组间比较,差异具有统计学意义(P0.05)。5.对冠心病组进行多元Logistic回归分析,结果认为收缩压、TC、TG、LDL-C、低血清羧化不全骨钙素水平是冠心病的独立危险因素。结论：1.血清羧化不全骨钙素水平与冠心病的类型及其冠状动脉病变程度密切相关。2.低血清羧化不全骨钙素水平是冠心病的独立危险因素,并可用于临床冠心病危险人群的及早发现。
[Abstract]:Objective: to investigate the relationship between serum carboxylation of incomplete osteocalcin and the type of coronary artery disease and the degree of coronary artery disease, and whether serum carboxylated incomplete osteocalcin level is an independent risk factor for coronary heart disease. Methods: 180 patients undergoing coronary angiography were selected as study objects. Collect patient history data, general data include: age, gender, diabetes history, hypertension history, smoking history, alcohol history. Laboratory data include: serum carboxylation incomplete osteocalcin, blood lipids, blood sugar and so on. Clinical parameters: systolic blood pressure, diastolic blood pressure, coronary angiography and echocardiography. According to the results of coronary angiography, 140 cases in coronary heart disease group and 40 cases in normal control group were divided into two groups. To compare the difference of clinical indexes between the two groups. According to the type of coronary heart disease, coronary heart disease group was divided into three groups: acute myocardial infarction (AMI), unstable angina pectoris (UAP), stable angina pectoris (SAP). At the same time, according to the number of vessel branches, they were divided into two groups: single vessel group and multi-vessel lesion group. The serum carboxylation incomplete osteocalcin levels were compared among each group. To investigate the correlation between serum carboxylated osteocalcin and severity of coronary artery disease according to Gensini score. Multivariate Logistic regression analysis was performed to determine whether serum carboxylation of osteocalcin was an independent risk factor for coronary heart disease (CHD). The result is 1: 1. The level of serum carboxylation incomplete osteocalcin in coronary heart disease group was significantly lower than that in non-coronary heart disease group [(1.02 卤0.35) ng/ml vs (1.32 卤0.51) ng/ml], the difference was statistically significant (P0.05) .2. Serum carboxylated osteocalcin levels in SAP group were (1.22 卤0.38) ng/ml, (1.04 卤0.23) ng/ml, (0.89 卤0.21) ng/ml., respectively. Serum carboxylation incomplete osteocalcin levels in the three groups were significantly lower than that in the non-coronary heart disease group (1.32 卤0.51) ng/ml, difference was statistically significant (P0.05) .3. The serum carboxylation incomplete osteocalcin levels were (1.32 卤0.51) ng/ml, (1.10 卤0.36) ng/ml, (0.97 卤0.34) ng/ml o in normal control group, (1.32 卤0.51) ng/ml, in single group and (0.97 卤0.34) ng/ml o in multivessel lesion group. The serum level of osteocalcin in multivessel lesion group was significantly lower than that in single vessel lesion group (P0.05). 4. Serum carboxylation incomplete osteocalcin levels were (0.96 卤0.32) ng/ml, (1.12 卤0.34) ng/ml, in Gensini high score group and (0.96 卤0.32) ng/ml, in Gensini low score group, the difference was statistically significant (P0.05). Multivariate Logistic regression analysis was performed in patients with coronary heart disease. The results showed that the low serum carboxylation incomplete osteocalcin level was an independent risk factor for coronary heart disease. Conclusion 1. The level of serum carboxylation incomplete osteocalcin was closely related to the type of coronary heart disease and the severity of coronary artery disease. Low serum carboxylation incomplete osteocalcin level is an independent risk factor for coronary heart disease and can be used for early detection of clinical coronary heart disease risk population.
【学位授予单位】：湖南师范大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R541.4

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