摘要
目的 探索三维定量冠脉造影(3D QCA)联合血清神经肽Y(神经肽Y)、1-磷酸鞘氨醇(S1P)在冠状动脉临界病变评估中的应用价值.方法 选取在2022年1月至2024年3月洪湖市中医医院收治的225例冠状动脉病变患者基本资料进行回顾性分析.根据血管病变狭窄程度分为两组,即观察组(冠状动脉临界病变,病变血管狭窄程度50％～70％,n=112)、对照组(病变血管狭窄程度＜50％,n=113).两组均进行3D QCA检查以及血清神经肽Y、S1P检测Gensini评分评估,对比两组面积狭窄程度、血管病变长度、直径狭窄程度、神经肽Y、S1P水平及Gensini评分;经Pearson法分析Gensini评分与3D QCA参数及血清指标的相关性;经受试者操作特征(ROC)曲线分析各项指标诊断效能.结果 观察组面积狭窄程度、血管病变长度、直径狭窄程度、神经肽Y、SlP、Gensini评分分别为(78.95±10.65)％、(28.45±15.65)mm、(61.68±8.23)％、(211.65±39.71)ng/L、(324.65±58.95)nmol/L、(65.65±12.32)分,均高于对照组[(62.28±7.36)％、(17.41±12.33)mm、(46.31±9.98)％、(165.42±37.55)ng/L、(265.65±57.49)nmol/L、(48.79±10.33)分],差异均有统计学意义(P＜0.05).经Pearson法分析,冠脉临界病变患者面积狭窄程度、血管病变长度、直径狭窄程度、神经肽Y、S1P与Gensini评分均呈正相关(r=0.307、0.260、0.313、0.645、0.544,P＜0.05).经ROC曲线分析,面积狭窄程度、血管病变长度、直径狭窄程度、神经肽Y、S1P及联合诊断冠状动脉临界病变的AUC分别为0.850、0.704、0.854、0.791、0.745、0.926.结论 神经肽Y、S1P水平联合三维定量冠脉造影能够准确诊断冠状动脉临界病变,具有较高效能.
Abstract
Objective To explore the application value of three-dimensional quantitative coronary angiography(3D QCA)combined with serum neuropeptide Y and sphingosine 1-phosphate(S1P)in the evaluation of critical coronary artery lesions.Methods The basic data of 225 patients with coronary artery disease admitted to Honghu Hospital of Traditional Chinese Medicine from January 2022 to March 2024 were retro-spectively analyzed.They were divided into two groups,namely the control group(＜50％,n=113),the observation group(critical coronary ar-tery stenosis,50％-70％,n=112),quantitative coronary angiography and serum neuropeptide Y,S1P tests,comparing the two groups of area stenosis,vascular lesion length,diameter stenosis degree,neuropeptide Y,S1P level and Gensini score,the correlation between Gensini score and 3D QCA parameters and serum indexes was analyzed by Pearson method,and the diagnostic efficacy analyzed by receiver operating characteristic(ROC)curve.Results Area stenosis,vascular lesion length,diameter stenosis,neuropeptide Y,S1P and Gensini score were(78.95±10.65)％,(28.45±15.65)mm,(61.68±8.23)％,(211.65±39.71)ng/L,(324.65±58.95)nmol/L,(65.65±12.32)points,which were higher than the control group[(62.28±7.36)％,(17.41±12.33)mm,(46.31±9.98)％,(165.42±37.55)ng/L,(265.65±57.49)nmol/L,(48.79±10.33)points],the differences were statistically significant(P＜0.05).According to Pearson analysis,the de-gree of area stenosis,vascular lesion length,diameter stenosis,neuropeptide Y,S1P were positively related to Gensini score(r=0.307,0.260,0.313,0.645,0.544;P＜0.05).According to the ROC curve analysis,the AUC of area stenosis,length of vascular lesions,diameter stenosis,NPY,S1 P,and combined diagnosis of critical coronary lesions were 0.850,0.704,0.854,0.791,0.745,and 0.926,respectively.Conclusion Neuropeptide Y and S1P levels combined with 3D QCA can accurately diagnose critical coronary artery lesions with high efficiency.
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