目的:探讨血浆硫酸吲哚酚(IS)水平对不稳定型心绞痛(UA)的诊断价值及其与冠状动脉斑块负荷的相关性.方法:收集接受冠状动脉造影的患者372例,其中UA患者177例(UA组)、冠状动脉粥样硬化(CAS)患者120例(CAS组)及冠状动脉造影未见异常者75例(对照组).应用靶向快速分辨液相色谱质谱法检测血浆中IS水平.应用心脏外科与介入治疗狭窄冠状动脉研究(SYNTAX)评分量化冠状动脉斑块负荷.结果:UA组患者血浆IS水平高于CAS组及对照组(P均＜0.05).多因素Logistic回归分析显示IS是罹患UA的独立危险因素(OR=2.90,95％CI:1.89～4.44,P＜0.001).趋势性检验中,依据IS三分位数,将IS分为T1、T2、T3组,在校正混杂因素后,UA患病风险随血浆 IS 水平升高而逐渐增加[OR(95％CI):T2 vs.T1:1.99(1.13～3.50),P=0.018;T3vs.T1:5.18(2.88～9.29),P＜0.001;趋势性检验P＜0.001].IS预测UA的受试者工作特征(ROC)曲线下面积为0.69(95％CI:0.63～0.74,P＜0.001).IS 水平与 UA 患者 SYNTAX 评分呈正相关(r=0.52,P＜0.001).多因素 Logistic回归显示IS(OR=4.34,95％CI:2.27～8.31,P＜0.001)是UA患者中/高SYNTAX评分的危险因素.结论:IS是诊断UA的独立预测因子,且与UA患者冠状动脉斑块负荷严重程度呈正相关.
Plasma indoxyl sulfate levels have diagnostic value for unstable angina and are correlated with coronary atheroscle-rotic burden
Objective:To evaluate the diagnostic value of indoxyl sulfate(IS)in unstable angina pectoris(UA)and its correlation with coronary atherosclerotic plaque burden.Methods:A total of 372 patients who underwent coronary angiogra-phy were selected consecutively.The selected patients were divided into three groups:UA group(177 cases),coronary ath-erosclerosis(CAS)group(120 cases)and control group(75 cases).The levels of plasma IS were determined by targeted liquid chromatography/mass spectrometry.Coronary atherosclerotic burden was quantified using the Synergy Between Percu-taneous Coronary Intervention with Taxus and Cardiac Surgery(SYNTAX)score.Results:The plasma IS levels in the UA group were higher than those in CAS group and control group(P＜0.05).Multivariate logistic regression analysis showed that IS(OR=2.90,95％CI:1.89-4.44,P=0.001)was a risk factor for UA.After adjusting for confounding factorsin the linear trend test,the risk of UA increased gradually with rising plasma IS levels[OR(95％CI):T2 vs.T1:1.99(1.13-3.50),P=0.018;T3 vs.T1:5.18(2.88-9.29),P＜0.001;P for trend＜0.001].The area under the ROC curve predicted by IS for UA was 0.69(95％CI:0.63-0.74,P＜0.001).The level of IS was positively correlated with the SYNTAX score of UA patients(r=0.52,P＜0.001).Multivariate logistic regression showed IS(OR=4.34,95％CI:2.27-8.31,P＜0.001)was a risk factor for the medium/high SYNTAX score of the patients with UA.Conclusions:IS is an independent predictor for diagnosing UA and is positively correlated with the severity of coronary atherosclerotic burden in UA patients.
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