Expression of Serum H-FABP， Platelet Activating Factor and IMA in Patients with Coronary Heart Disease and Its Clinical Implications
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摘要:
目的 探讨血清心脏型脂肪酸结合蛋白（H-FABP）、血小板活化因子（PAF）及缺血修饰白蛋白（IMA）在冠心病患者中的表达及其临床意义。 方法 收集2017年4月至2019年10月期间在青岛市第八人民医院述胸痛并进行冠脉造影检查的168例患者为研究对象，根据冠脉造影结果将其分为对照组（n = 30）、稳定型心绞痛（SAP）组（n = 55）、不稳定性心绞痛（UAP）组（n = 51）和急性心肌梗死（AMI）组（n = 32）。比较各组血清H-FABP、PAF和IMA水平，采用多因素Logistic回归分析冠心病发生的影响因素，采用Pearson法分析全球急性冠脉综合征事件注册（GRACE）评分与血清H-FABP、PAF和IMA水平的相关性，采用受试者工作特征曲线（ROC）曲线分析各个指标对冠心病的诊断价值。 结果 AMI组GRACE评分及血清H-FABP、PAF和IMA水平最高，其次为UAP组，SAP组次之，对照组最低（P < 0.05）。GRACE评分及血清H-FABP、PAF和IMA水平是冠心病发生的独立危险因素（ OR = 1.993、2.325、1.741和2.208，P < 0.05）。GRACE评分与血清H-FABP、PAF和IMA水平均呈正相关性（ r = 0.9023，0.8967和0.9364，P < 0.05）。血清H-FABP、PAF和IMA联合诊断冠心病的诊断价值明显高于各项指标单独检测。 结论 血清H-FABP、PAF和IMA水平升高是冠心病发生的主要危险因素，并且血清H-FABP、PAF和IMA水平与GRACE评分均呈正相关性，血清H-FABP、PAF和IMA联合检测在冠心病的临床诊断中具有一定临床意义。 -
关键词:
- 心脏型脂肪酸结合蛋白 /
- 血小板活化因子 /
- 缺血修饰白蛋白 /
- 冠脉造影 /
- GRACE评分
Abstract:Objective To investigate the expression of serum H-FABP, platelet activating factor （PAF） and ischemia-modified albumin （IMA） in patients with coronary heart disease and its clinical implications. Methods 168 patients who reported chest pain and underwent coronary angiography in Qingdao 8th People's Hospital from April 2017 to October 2019 were enrolled as subjects. Based on the results of coronary angiography, subjects were divided into control group （n = 30）, SAP group （n = 55）, UAP group （n = 51） and AIM group （n = 32）. Serum H-FABP, PAF and IMA levels in each group were compared. Influencing factors of coronary heart disease were analyzed by multivariate logistic regression. The correlation between GRACE score and serum H-FABP, PAF and IMA levels was analyzed by Pearson method. The receiver operating Characteristic curve （ROC） was used to analyze the diagnostic value of each indicator for coronary heart disease. Results GRACE score and serum H-FABP, PAF and IMA levels were the highest in AMI group, followed by UAP group, SAP group, and control group （P < 0.05）. GRACE scores and serum H-FABP, PAF, and IMA levels were independent risk factors for coronary heart disease （ OR = 1.993, 2.325, 1.741, and 2.208, P < 0.05）. GRACE score was positively correlated with serum H-FABP, PAF and IMA levels （ r = 0.9023, 0.8967 and 0.9364, P < 0.05）. In diagnosing coronary heart disease, the diagnostic value of serum H-FABP, PAF and IMA combined was significantly higher than that of each indicator alone. Conclusion Elevated serum H-FABP, PAF and IMA levels are major risk factors for coronary heart disease, and serum H-FABP, PAF and IMA levels are positively correlated with GRACE scores. Detection of serum H-FABP, PAF and IMA combined are of value in the clinical diagnosis of coronary heart disease. -
Key words:
- H-FABP /
- Platelet activating factor /
- Ischemic modified albumin /
- Coronary angiography /
- GRACE score
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图 1 GRACE评分与血清H-FABP、PAF和IMA水平的相关性分析
A：GRACE评分与血清H-FABP水平的相关性分析；B：GRACE评分与血清PAF水平的相关性分析；C：GRACE评分与血清IMA水平的相关性分析。
Figure 1. Correlation analysis between GRACE score and serum H-FABP，PAF and IMA levels
图 2 血清H-FABP、PAF和IMA水平对冠心病的诊断价值
Figure 2. The diagnostic value of serum H-FABP，PAF and IMA levels in coronary heart disease
表 1 各组临床资料比较（
$\bar x \pm s$ ）Table 1. Comparison of clinical data of each group（
$\bar x \pm s$ ）临床指标 对照组（n = 30） SAP组（n = 55） UAP组（n = 51） AMI组（n = 32） χ2/F P 性别（男/女） 16/14 29/26 27/24 18/14 0.117 0.990 年龄（岁） 50.19 ± 8.23 52.73 ± 7.75 49.18 ± 7.81 51.27 ± 7.89 1.412 0.162 BMI（kg/m2） 23.76 ± 3.90 23.31 ± 3.43 24.01 ± 3.81 23.96 ± 3.69 0.551 0.583 糖尿病史（无/有） 11/19 25/30 23/28 18/14 2.428 0.488 吸烟史（无/有） 11/19 14/41 20/31 16/16 5.584 0.134 高血压史（无/有） 10/20 23/32 26/25 14/18 2.487 0.478 总胆固醇（mmol/L） 4.16 ± 0.68 5.09 ± 0.75 5.31 ± 0.84 5.65 ± 0.87 1.924 0.058 三酰甘油（mmol/L） 3.02 ± 0.50 3.21 ± 0.56 3.35 ± 0.53 3.64 ± 0.56 1.743 0.085 低密度脂蛋白（mmol/L） 4.89 ± 0.80 5.21 ± 0.77 5.46 ± 0.87 5.78 ± 0.89 1.810 0.074 高密度脂蛋白（mmol/L） 1.73 ± 0.28 1.38 ± 0.20 1.22 ± 0.19 1.13 ± 0.17 1.722 0.089 GRACE评分（分） 85.62 ± 14.04 96.73 ± 14.23 106.59 ± 16.92 155.71 ± 23.96 3.457 0.001* H-FABP（ng/mL） 3.08 ± 0.50 8.07 ± 1.19 9.17 ± 1.46 23.41 ± 3.60 21.926 < 0.001* PAF（ng/mL） 6.18 ± 1.01 11.59 ± 1.70 12.47 ± 1.98 18.52 ± 2.85 15.895 < 0.001* IMA（ng/mL） 64.16 ± 10.52 82.35 ± 12.11 89.68 ± 14.23 98.72 ± 15.19 6.921 < 0.001* *P < 0.05。 
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表 2 冠心病发病影响因素的多因素Logistic回归分析
Table 2. Multivariate Logistic regression analysis of influencing factors of coronary heart disease
临床相关资料 β SE（β） Wald χ2 P OR 95%CI 下限 上限 GRACE评分 0.689 0.103 12.315 0.001 1.993 1.235 3.183 H-FABP 0.842 0.131 16.456 0.001 2.325 1.576 3.183 PAF 0.651 0.014 14.061 0.001 1.741 1.425 2.937 IMA 0.775 0.108 15.609 0.001 2.208 1.608 2.873
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