摘要
目的探讨血浆可溶性尿激酶型纤溶酶原激活物受体(su PAR)水平与冠心病患者冠状动脉斑块稳定性、病变程度及冠心病预测之间的关系。方法 149例入选患者,根据临床表现及冠状动脉造影结果分为急性冠状动脉综合征(ACS)组69例、稳定型心绞痛(SAP)组35例和对照组45例,ELISA检测血浆su PAR水平,比较各组血浆su PAR水平,分析血浆su PAR水平与冠心病的相关性,观察其与冠状动脉病变支数及Gensini积分的关系,并绘制su PAR预测冠心病发生的ROC曲线,确定最佳界值。结果 ACS组、SAP组血浆su PAR水平高于对照组(P<0.05),ACS组血浆su PAR水平高于SAP组(P<0.05);随着冠状动脉病变支数增加,冠心病患者血浆su PAR水平相应增加(P<0.05),且与Gensini积分呈正相关(r=0.202,P<0.05);简单及偏相关分析显示,血浆su PAR水平与冠心病呈正相关性;多因素Logistic回归分析显示,su PAR是冠心病发生的独立危险因素(OR=3.405,P<0.01);根据ROC曲线获得su PAR预测冠心病发生的最佳界值为1.771μg/L,曲线下面积(AUC)为0.745(95%CI=0.661~0.828,P<0.001)。结论 su PAR作为冠心病发生的独立危险因素,不仅能对粥样斑块稳定性具有提示性,且与冠状动脉病变程度呈正相关,su PAR界值有可能成为预测冠心病发生的指标之一。
Aim To explore the correlation between plasma soluble urokinase-type plasminogen activator receptor( su PAR) level and coronary atherosclerotic plaque stability,coronary lesions severity in patients with coronary heart disease( CHD) and prediction of CHD. Methods 149 enrolled patients were divided into acute coronary syndrome( ACS) group( 69 cases),stable angina pectoris( SAP) group( 35 cases) and control group( 45 cases) according to the clinical manifestation and angiographic results. Plasma su PAR levels measured by enzyme linked immunosorbent assay( ELISA) were compared among the groups. The correlation between plasma su PAR level and CHD was analyzed. The relationships of plasma su PAR level with coronary lesions count and Gensini score were studied. ROC curve was performed to evaluate the predictive performance of su PAR for CHD and to identify the optimal cut-off value for predicting the presence of CHD. Results The plasma su PAR levels in ACS group and SAP group were higher than that in control group( P < 0. 05),and plasma su PAR level was significantly higher in ACS group compared to the SAP group( P <0. 05). Statistically signi cant correlations were observed between plasma su PAR level and the number of diseased vessels( P < 0. 05) and Gensini score( P < 0. 05). Using simple and partial correlation analysis,plasma su PAR level was positively correlated with CHD. In addition,multivariate Logistic regression analysis revealed that su PAR was an independent risk factor of CHD( OR = 3. 405,P < 0. 01). The ROC curve showed that the optimal cut-off point for su PAR to predict CHD was 1. 771 μg / L. The area under the ROC curve was 0. 745( 95% CI = 0. 661 ~ 0. 828,P < 0. 001). Conclusions Plasma su PAR level was positively correlated with atherosclerotic plaque stability and coronary lesions severity in patients with CHD. su PAR may serve as an independent risk factor of CHD. The cut-off value of su PAR may be one of the indicators to predict CHD.
出处
《中国动脉硬化杂志》
CAS
北大核心
2015年第12期1236-1240,共5页
Chinese Journal of Arteriosclerosis
基金
国家自然科学基金(81300220)
