摘要
目的探讨冠心病(CAD)患者血浆致动脉硬化指数(AIP)及炎症因子水平与冠状动脉钙化积分的相关性,并评价其对冠状动脉钙化(CAC)的辅助诊断价值。方法回顾性连续选入2019年6月至2020年6月就诊于保定市第一中心医院,经冠状动脉CT血管造影(CTA)及冠状动脉造影诊断的CAD患者241例,依据冠状动脉CTA是否存在钙化分为CAC组63例、非CAC组178例。收集患者临床资料,采用酶联免疫吸附法检测血清炎症因子水平。分析CAC积分与AIP及炎症因子水平的相关性,并评价AIP及炎症因子对CAD患者CAC形成的诊断价值。结果CAC组患者的AIP及血清骨保护素(OPG)、清软骨寡聚基质蛋白(COMP)水平高于非CAC组,而血清成纤维细胞生长因子21(FGF21)水平低于非CAC组,差异均有统计学意义(均P<0.01)。相关性分析发现,CAD患者的CAC积分与AIP及OPG、COMP水平呈正相关(r=0.581、0.451、0.326,P<0.05),与FGF21水平呈负相关(r=-0.294,P<0.05)。ROC曲线分析显示,AIP、OPG、COMP及FGF21对CAD患者CAC形成具有诊断价值(均P<0.05)。AIP>0.387、OPG>5.150 ng/ml、FGF21≤136.35 pg/ml、COMP>733.16 ng/ml是CAD患者CAC形成的独立危险因素(均P<0.05)。结论AIP升高、炎症因子水平改变可作为辅助诊断CAD患者CAC形成的标志物。
Objective The aims of the study were to investigate the relationship among atherogenic index of plasma(AIP)and inflammatory adipocytokines with the severity of coronary artery calcification(CAC)score in coronary artery disease(CAD).And then we analyzed the diagnostic value of the new markers on CAC.Methods A total of 241 patients with CAD diagnosed by coronary CT angiography(CTA)and coronary angiography in Baoding First Central Hospital from June 2019 to June 2020 were retrospectively enrolled.According to the presence of calcification in coronary CTA,they were divided into CAC group(n=63)and non-CAC group(n=178).The clinical data of the patients were collected,and the levels of serum inflammatory factors were measured by enzyme-linked immunosorbent assay(ELISA).The correlation between CAC score and AIP and inflammatory cytokines was analyzed.The diagnostic value of AIP and inflammatory factors in the formation of CAC in patients with CAD.Results The levels of AIP,serum osteoprotegerin(OPG)and oligomeric matrix protein(COMP)in CAC group were higher than those in non-CAC group,while the levels of serum fibroblast growth factor 21(FGF21)were lower than those in non-CAC group,with statistically significant difference(all P<0.01).Correlation analysis showed that CAC score of CAD patients was positively correlated with AIP,OPG and COMP(r=0.581,0.451,0.326,P<0.05),and negatively correlated with FGF21(r=-0.294,P<0.05).Receiver operating characteristic(ROC)curve analysis showed that AIP,OPG,COMP and FGF21 had diagnostic value for CAC in CAD patients(all P<0.05).AIP>0.387,OPG>5.150 ng/ml,FGF21>136.35 pg/ml,COMP>733.16 ng/ml were independent factors affecting the formation of CAC(all P<0.05).Conclusions The increase of AIP and the change of inflammatory factors can be used as markers for the diagnosis of CAC formation in CAD patients.
作者
房伟
方艳辉
耿巍
单新军
刘成
陈晨
马小茹
刘晶晶
姜爱华
Fang Wei;Fang Yanhui;Geng Wei;Shan Xinjun;Liu Cheng;Chen Chen;Ma Xiaoru;Liu Jingjing;Jiang Aihua(Department of Cardiology,the First Central Hospital of Baoding,Baoding 071000,China;Hebei College of Science and Technology,Baoding 071000,China)
出处
《中国医师杂志》
CAS
2022年第9期1368-1372,共5页
Journal of Chinese Physician
关键词
冠心病
血管钙化
血浆致动脉硬化指数
炎症因子
冠状动脉钙化积分
Coronary artery disease
Vascular calcification
Atherogenic index of plasma
Inflammatory cytokines
Coronary artery calcification score
