摘要
目的探讨血清γ-谷氨酰胺转移酶(γ-GT)水平与高血压患者冠状动脉钙化(CAC)积分之间的关系。方法选取2016年1月~2017年6月于湖南中医药大学第一附属医院就诊并行冠状动脉CT检查的高血压患者218例为研究对象。根据CAC积分将患者分为CAC组(CAC积分>0;n=120)和非CAC组(CAC积分=0;n=98),并比较两组患者的临床资料。采用多因素Logistic回归分析探究CAC的预测因素,并以ROC曲线描述其预测价值。结果 CAC组患者的γ-GT水平为(30.4±10.7)U/L,而非CAC组为(26.1±11.9)U/L,差异具有统计学意义(P=0.006)。与非CAC组相比,CAC组患者的年龄、男性比、吸烟比、空腹血糖和高敏C反应蛋白较高,而其高密度脂蛋白胆固醇(HDL-C)水平较低(P均<0.05)。多因素Logistic回归分析结果提示,血清γ-GT水平(OR=1.23,95%CI:1.03~1.47,P=0.022)、年龄(OR=1.14,95%CI:1.07~1.22,P<0.001)、吸烟(OR=2.07,95%CI:1.26~1.47,P=0.004)和空腹血糖水平(OR=1.31,95%CI:1.02~1.69,P=0.036)。ROC曲线分析表明,γ-GT预测CAC的曲线下面积为0.78(95%CI:0.0.71~0.85)。预测的最佳截点为28.4 U/L,其敏感性为67%,特异性为78%。结论高血压患者的血清γ-GT水平与CAC密切相关,对预测CAC有一定价值。
Objective To examine the association between serum level ofγ-glutamyltransferase(γ-GT)and coronary artery calcification(CAC)score in patients with hypertension.Methods A total of 218 patients who received coronary CT testing in the First Hospital of Hunan University of Chinese Medicine were selected.According to the CAC score,the patients were divided into the CAC group(CAC score>0;n=120)and non-CAC group(CAC score=0;n=98),and the clinical data between these two groups were compared.The influence factors for CAC were detected by multivariate logistic regression analysis,and ROC curve analysis was used to describe the predictive value.Results Theγ-GT level was(30.4±10.7)U/L in the CAC group and(26.1±11.9)U/L in the non-CAC group,with significant difference between the groups(P=0.006).Compared with the non-CAC group,the age,percentage of men,percentage of smokers,fasting blood glucose and high-sensitivity C-reactive protein in the CAC group was higher and the high-density lipoprotein cholesterol was lower(all P<0.05).Multivariate Logistic analyses indicated thatγ-GT level(OR=1.23,95%CI:1.03~1.47;P=0.022),age(OR=1.14,95%CI:1.07~1.22;P<0.001),smoking(OR=2.07,95%CI:1.26~1.47;P=0.004)and fasting blood glucose(OR=1.31,95%CI:1.02~1.69;P=0.036)are independent predictors of CAC.ROC curve analysis suggested that the area under the curve ofγ-GT level in predicting CAC was 0.78(95%CI:0.71~0.85).The optimal cut-off value for prediction was 28.4 U/L,with a sensitivity of 67%and a specificity of 78%.Conclusion In hypertensive patients,serumγ-GT level is closely associated with the presence of CAC,and it is also an independent predictor for CCC.
作者
苏敏
朱惠斌
赵宁志
陈锋
宁兴旺
李萍
谢小兵
Su Min;Zhu Huibin;Zhao Ningzhi;Chen Feng;Ning Xingwang;Li Ping;Xie Xiaobing(Medical Laboratory and Pathology Center,the First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)
出处
《中国循证心血管医学杂志》
2018年第6期726-728,732,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
