Correlation Study of Blood Preβ1-HDL Predictive Value of Coronary Artery Disease Severity in Patients with Coronary Heart Disease
-
摘要:
目的 探讨preβ1-HDL对冠心病患者冠脉病变严重程度预测价值的相关性。 方法 在昆明市第一人民医院行冠脉介入诊断和\或治疗的90例患者，顺序入组，其中冠心病患者70例（其中冠心病单支病变15例，冠心病多支病变55例），冠脉正常患者20例。收集各组临床基线资料。采用ELISA法测定血preβ1-HDL浓度。用SPSS进行统计分析。 结果 在不同冠脉病变严重程度患者中血preβ1-HDL水平，差异有统计学意义（P < 0.05）。Preβ1-HDL浓度与冠脉Gensini评分呈正相关（P < 0.000），相关性为（r = 0.782）。Preβ1-HDL浓度与cTnT呈正相关（P < 0.000），相关性为（r = 0.421）。血Preβ1-HDL的ROC曲线下面积（AUC）为0.993，诊断界值为3.66，敏感度和特异度分别为100%和94.7%。 结论 初步发现血Preβ1-HDL浓度可以作为预测冠心病冠脉病变严重程度的新指标。 -
关键词:
- preβ1-HDL /
- 冠状动脉粥样硬化性心脏病 /
- 冠脉Gensini评分
Abstract:Objective To investigate the correlation between Pre β1-HDL and the predictive value of coronary artery disease severity in patients with coronary heart disease. Methods In this study, 90 patients undergoing coronary intervention diagnosis and/or treatment in our hospital were enrolled sequentially. Among them, there were 70 patients with coronary artery disease （including 15 patients with single coronary artery disease, 55 patients with multiple coronary artery disease）and 20 patients with normal coronary artery disease. Clinical baseline data of each group were collected. Blood preβ1-HDL concentration was determined by ELISA. SPSS was used for statistical analysis. Results The results of this study showed that blood pre β1-HDL levels in patients with different severity of coronary artery disease had the statistically significant differences （P < 0.05）. Preβ1-HDL concentration was positively correlated with coronary Gensini score （P < 0.000）, and the correlation was （r = 0.782）. Preβ1-HDL concentration was positively correlated with cTnT （P < 0.000）, and the correlation was （r = 0.421）. The area under ROC curve（AUC） of blood Pre β1-HDL was 0.993, the diagnostic threshold was 3.66, and the sensitivity and specificity were 100% and 94.7%, respectively. Conclusion Blood Pre β1-HDL concentration has been found to be a new indicator to predict the severity of coronary artery disease. -
图 1 血Preβ1HDL、cTnT、CKMB、Mb在冠心病诊断中的敏感性及特异性
Figure 1. Preβ1HDL、cTnT、CKMB、Mb in the diagnosis of CAD sensitivity and specificity
表 1 患者基线临床资料[（
$\bar x \pm s$ ）/（n）%]Table 1. patients baseline clinical data [（
$\bar x \pm s$ ）/（n）%]项目 所有患者（n = 90） 冠脉多支病变（n = 55） 冠脉单支病变（n = 15） 冠脉正常（n = 20） F/Z P 年龄（岁） 63.52 ± 9.89 65.91 ± 8.36 64.13 ± 11.10 56.10 ± 9.76 2.368 0.117 男性 48（53.3） 32（58.1） 8（50） 8（42.1） 0.034 0.784 吸烟（n）% 47（52.2） 32（58.2） 7（43.8） 8（42.1） 1.275 0.426 高血压（n）% 83（92.2） 51（92.7） 15（93.7） 17（89.5） 0.023 0.872 TG（mmol/L） 2.03 ± 1.40 2.17 ± 1.63 1.83 ± 0.98 1.80 ± 0.82 0.376 0.512 TC（mmol/L） 4.40 ± 1.23 4.42 ± 1.34 4.35 ± 1.25 4.39 ± 0.87 0.012 0.982 LDLC（mmol/L） 2.44 ± 0.98 2.50 ± 1.05 2.20 ± 1.01 2.47 ± 0.72 1.293 0.459 BUN（mmol/L） 5.71 ± 2.93 6.05 ± 3.41 5.11 ± 1.95 5.22 ± 1.83 0.972 0.382 Cr（µmol/L） 84.25 ± 49.87 89.08 ± 62.32 76.08 ± 13.50 77.16 ± 17.45 0.385 0.520 eGFR（mL/min） 91.42 ± 26.03 89.98 ± 28.49 94.31 ± 22.15 93.16 ± 22.08 0.033 0.802 K（mmol/L） 4.15 ± 0.39 4.16 ± 0.41 4.13 ± 0.26 4.10 ± 0.42 0.026 0.827 Na（mmol/L） 140.54 ± 2.79 140.36 ± 2.78 140.36 ± 2.93 141.25 ± 2.19 1.183 0.439 CL（mmol/L） 106.62 ± 3.43 106.28 ± 3.44 107.32 ± 3.54 107.00 ± 3.36 1.251 0.499 Hb（g/L） 141.90 ± 16.96 138.80 ± 16.93 145.00 ± 16.09 148.26 ± 16.29 2.748 0.124 PLT（×109/L） 217.81 ± 63.13 211.91 ± 60.90 212.12 ± 59.36 239.68 ± 70.71 1.473 0.238 WBC（×1012/L） 6.92 ± 2.37 6.98 ± 2.59 6.70 ± 2.20 6.93 ± 1.84 0.254 0.897 n百分比（n%） 64.94 ± 10.15 65.16 ± 11.01 64.67 ± 9.49 64.52 ± 8.37 0.117 0.934 HCY（mmol/L） 13.87 ± 4.61 14.17 ± 5.21 13.34 ± 3.08 13.45 ± 3.87 0.042 0.748 
下载: 导出CSV
表 2 在不同冠脉病变组中患者血preβ1-HDL的水平（
$\bar x \pm s$ ）Table 2. Blood Preβ1-HDL levels in patients with different coronary artery disease groups （
$\bar x \pm s$ ）项目 冠脉多支病变 冠脉单支病变 冠脉正常 P Preβ1-HDL（µg/mL） 10.69 ± 3.61 5.86 ± 2.22 2.66 ± 0.93 < 0.001* Gensini评分 61.07 ± 34.16 21.75 ± 21.06 − < 0.001* *P < 0.05。
下载: 导出CSV
表 3 Preβ1-HDL与冠脉Gensini评分及cTnT相关性分析
Table 3. Preβ1-HDL with coronary Gensini score and cTnT correlation analysis
Preβ1HDL r P 冠脉Gensini评分 0.782** < 0.001 hsCTnT 0.421** < 0.001 **在.01水平（双侧）上显著相关。
下载: 导出CSV
表 4 本研究中血Preβ1HDL、cTnT、CKMB、Mb在冠心病诊断中的ROC曲线
Table 4. ROC curve of the Preβ1HDL、cTnT、CKMB、Mbin the diagnosis of CAD
项目 CUT OFF 灵敏度（%） 特异度（%） AUC P Preβ1HDL（µg/mL） 3.66 100 94.7 0.993 0.000 cTnT（mmol/L） 0.009 73.2 78.9 0.744 0.001 CKMB（mmol/L） 1.65 67.6 63.2 0.669 0.024 Mb（mmol/L） 26 52.1 89.5 0.723 0.003
下载: 导出CSV
-
[1] Barter P J,Rye K A,Tardif J C,et al. Effect of torcetrapib on glucose,insulin,and hemoglobin A1c insubjects in the investigation of lipid level management to understand its impact in atherosclerotic events(ILLUMINATE)trial[J]. Circulation,2011,124(5):555-562. doi: 10.1161/CIRCULATIONAHA.111.018259 [2] Perez Mendez O,Pacheco H G,Martinez Sanchez C,et al. HDL-cholesterol in coronary artery disease risk:Function or structure?[J]. Clin Chim Acta,2014,429(9):111-122. [3] Brinton E A,Kher U,Shah S,et al. Effects of anacetrapib on plasma lipids in specific patient subgroups in the DEFINE(Determining the Efficacy and Tolerability of CETP Inhibition with Anacetrapib)trial[J]. J Clin Lipidol,2015,9(1):65-71. doi: 10.1016/j.jacl.2014.10.005 [4] 杨宁,胡立群,李红旗,等. 高密度脂蛋白组成部分中的不同亚类对冠状动脉狭窄程度影响的相关性研究[J]. 安徽医药,2015,19(6):1091-1094. doi: 10.3969/j.issn.1009-6469.2015.06.021 [5] Kontnsh A,Lhomme M. Unraveling the complexities of the HDL lipidome[J]. J Lipid Res,2013,54(11):2950-2963. doi: 10.1194/jlr.R036095 [6] Guey L T,Pullinger C R,lshida B Y,et al. Relation ofincreased pre beta-I high density lipoprotein levels to risk of coronary heart disease[J]. Am J Cardiol,2011,108(3):360-366. doi: 10.1016/j.amjcard.2011.03.054 [7] Asztalos B F,Cupples L A,Demissie S,et al. High-density lipoprotein subpopulation profile and coronary heart disease prevalence in male participants of the framingham Offspring Study[J]. Arterioscler Thromb Vase Biol,2004,24(11):2181-2187. doi: 10.1161/01.ATV.0000146325.93749.a8 [8] Asztalos B F,Collins D,Cupples L A,et al. Value of high density lipoprotein(HDL)subpopulations in predicting recurrent cardiovascular events in the veterans aflairs HDL intervention trial[J]. Arterioscler Thromb Vase Biol,2005,25(10):2185-2191. doi: 10.1161/01.ATV.0000183727.90611.4f [9] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 慢性稳定性心绞痛诊断与治疗指南[J]. 中华心血管病杂志,2007,35(3):195-206. doi: 10.3760/j.issn:0253-3758.2007.03.002 [10] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 非ST段抬高急性冠状动脉综合征诊断和治疗指南[J]. 中华心血管病杂志,2012,40(5):353-367. doi: 10.3760/cma.j.issn.0253-3758.2012.05.001 [11] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南[J]. 中华心血管病杂志,2015,43(5):380-393. doi: 10.3760/cma.j.issn.0253-3758.2015.05.003 [12] 中华医学会心血管病学分会介入心脏病学组,中华心血管病杂志编辑委员会. 中国经皮冠状动脉介入治疗指南2012(简本)[J]. 中华心血管病杂志,2012,40(4):271-277. doi: 10.3760/cma.j.issn.0253-3758.2012.04.003 [13] Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease[J]. Am J Cardiol,1983,51(3):606. doi: 10.1016/S0002-9149(83)80105-2 [14] Tuteja S,Rader DJ. High-density lipoproteins in the prevention of cardiovascular disease:Changing the paradigm[J]. Clin Pharma· col Ther,2014,96(1):48-56. [15] 李南方,林娜,姚晓光,等. MK2、ZFP36基因变异与新疆维吾尔族人群高密度脂蛋白胆固醇水平的相关性[J]. 中华医学遗传学杂志,2013,30(3):345-350. doi: 10.3760/cma.j.issn.1003-9406.2013.03.021 [16] 杨丽萍,张国华. 脑梗死患者颈动脉粥样硬化斑块与血清YKL40、OX-LDL水平的相关性[J]. 中国医师杂志,2013,15(4):449-452. doi: 10.3760/cma.j.issn.1008-1372.2013.04.005 [17] Tian L,Li C,Liu Y,et al. The value and distribution of high-density lipoprotein subclass in patients with acute coronary syndrome[J]. PLoS One,2014,9(1):e85114. doi: 10.1371/journal.pone.0085114 [18] Tani M,Horvath K V,Lamarche B,et al. High-density lipoprotein subpopulation profiles in lipoprotein lipase and hepatic lipase deficiency[J]. Atherosclerosis.,2016,253(10):7-14. [19] Asztalos B F,Horvath K V. High-density lipoprotein particles,cell-cholesterol efflux,and coronary heart disease risk[J]. Arterioscler Thromb Vasc Biol.,2018,38(9):2007-2015. doi: 10.1161/ATVBAHA.118.311117 [20] Asztalos B F,Horvath K V,Mehan M,et al. Influence of HDL particles on cell-cholesterol efflux under various pathological conditions[J]. J Lipid Res,2017,58(6):1238-1246. doi: 10.1194/jlr.M075648 [21] Getz G S,Reardon CA. Apoprotein E and reverse cholesterol transport[J]. Int JMol Sci,2018,19(11):E3479. [22] Rohatgi A,Khera A,Berry J D,et al. HDL cholesterol efflux capacity and incident cardiovascular events[J]. N Engl J Med,2014,37l(25):2383-2393. [23] Khem A V,Cuchel M,de la Llera-Moya M,et al. Cholesterol efflux capacity,high-density lipoprotein function,and atherosclerosis[J]. N Engl JMed,2011,364(2):127-135. doi: 10.1056/NEJMoa1001689 [24] Saleheen D,Scoa R,Javad S,et al. Association of HDL cholesterol efflux capacity with incident coronary heart disease events:A prospective case-control study[J]. Lancet Diabetes Endoerin01,2015,3(7):507-513. doi: 10.1016/S2213-8587(15)00126-6 [25] Ishikawa T,Ayaori M,Uto-Kondo H,et al. High-density lipoprotein cholesterol efflux capacity as a relevant predictor of atherosclerotic coronary disease[J]. Atherosclerosis,2015,242(1):318-322. doi: 10.1016/j.atherosclerosis.2015.06.028 [26] 肖梨花,李娜,丁岚,等. 血浆胆固醇含量对代谢综合征患者HDL亚类分布的影响[J]. 中国动脉硬化杂志,2015,23(5):509-514. [27] 李红旗,杨宁,胡立群,等. 冠脉狭窄度与高密度脂蛋白亚类关系分析[J]. 临床心电学杂志,2015,24(2):117-121. [28] 郑林琼,卢静,叶吉明. 血尿酸、低密度脂蛋白与老年女性冠心病患者冠脉狭窄程度的相关性[J]. 昆明医科大学学报,2019,40(6):90-92. doi: 10.3969/j.issn.1003-4706.2019.06.019 [29] 李凤芹,聂宏刚,刘友斌. Preβ-1高密度脂蛋白与心血管疾病关系的研究进展[J]. 中国心血管病研究,2019,17(1):5-8. doi: 10.3969/j.issn.1672-5301.2019.01.002 -
点击查看大图
图(1) / 表(4)
计量
- 文章访问数: 3375
- HTML全文浏览量: 1824
- PDF下载量: 5
- 被引次数: 0
