首页|冠心病患者血清ANGPTL3、ox-LDL、CRP/ALB与冠状动脉病变的相关性研究

冠心病患者血清ANGPTL3、ox-LDL、CRP/ALB与冠状动脉病变的相关性研究

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目的 探究冠心病患者血清血管生成素蛋白3(ANGPTL3)、氧化低密度脂蛋白(ox-LDL)、C反应蛋白(CRP)/白蛋白(ALB)与冠状动脉病变的相关性.方法 选取2022年1月至2023年5月行冠状动脉造影检查的247例患者作为研究对象,根据检查结果将患者分为冠心病组(n=143)与非冠心病组(n=104),进一步根据Gensini积分将冠心病组患者按照冠状动脉病变情况分为轻度组(Gensini积分<30分,n=83)与重度组(Gensini积分≥30分,n=64).比较各组血清ANGPTL3、ox-LDL、CRP/ALB水平,采用多因素logistic回归分析冠心病患者冠状动脉病变的影响因素,采用Spearman相关性分析冠心病患者血清ANGPTL3、ox-LDL、CRP/ALB与冠状动脉病变的相关性,采用受试者操作特征(ROC)曲线与曲线下面积(AUC)值分析血清ANGPTL3、ox-LDL与CRP/ALB对冠心病患者冠状动脉病变程度的预测效能.结果 冠心病组ANGPTL3、ox-LDL、CRP/ALB均高于非冠心病组(P均<0.05);两组尿酸水平比较无显著差异(P>0.05).重度组三酰甘油(TG)、总胆固醇(TC)、低/高密度脂蛋白胆固醇(LDL-C/HDL-C)、胱抑素(CysC)水平高于轻度组,β2微球蛋白(β2-MG)水平低于轻度组(P均<0.05);重度组ANGPTL3、ox-LDL、CRP/ALB均高于轻度组(P均<0.05).多因素logistic回归分析结果显示CysC、ANGPTL3、ox-LDL、CRP/ALB为冠心病患者冠状动脉病变的影响因素(P均<0.05).Spearman相关性分析结果显示血清ANGPTL3、ox-LDL及CRP/ALB与Gensini积分呈正相关(P均<0.05).血清ANGPTL3、ox-LDL及CRP/ALB预测冠心病患者冠状动脉病变程度时,以ANGPTL3的AUC值最高(0.986),灵敏度、特异度分别为96.87%、96.39%;以ox-LDL的AUC值最低(0.678),灵敏度、特异度分别为56.25%、75.90%,3项指标的ROC曲线比较具有显著差异(P<0.05).结论 血清ANGPTL3、ox-LDL及CRP/ALB与冠心病患者冠状动脉病变呈正相关,ANGPTL3对患者冠状动脉病变程度的预测效能最佳,临床可优先选择ANGPTL3并结合ox-LDL、CRP/ALB对冠心病冠状动脉病变严重程度进行判定.
Correlation between Serum ANGPTL3,ox-LDL,CRP/ALB Ratio and Coronary Artery Lesions in Patients with Coronary Heart Disease
Objective To investigate the correlation between serum angiopoietin-like 3(ANGPTL3),oxidized low-density lipoprotein(ox-LDL),C-reactive protein(CRP)/albumin(ALB)and coronary artery lesions in patients with coronary heart disease(CHD).Methods 247 patients who received coronary angiography in the hospital from January 2022 to May 2023 were selected as the study subjects.Based on the examination results,the patients were divided into CHD group(n=143)and non-CHD group(n=104).According to the condition of coronary lesions(Gensini score),patients in the CHD group were divided into mild group(Gensini score<30,n=83)and severe group(Gensini score≥30,n=64).Serum ANGPTL3,ox-LDL,and CRP/ALB were compared between groups.Multivariate logistic regression analysis was conducted to identify the influencing factors of coronary artery lesions in patients with CHD.Spearman correlation analysis was conducted to discuss the correlation between serum ANGPTL3,ox-LDL,CRP/ALB and coronary artery lesions in patients with CHD.Predictive efficacy of serum ANGPTL3,ox LDL,and CRP/ALB in predicting coronary artery disease severity in CHD patients using receiver operating characteristic(ROC)curve and area under curve(AUC)value analysis.Results ANGPTL3,ox-LDL,and CRP/ALB in the CHD group were higher than those in the non-CHD group(all P<0.05).There was no signifiicant difference in uric acid level between the two groups(P>0.05).The levels of triglyceride(TG),total cholesterol(TC),low/high-density lipoprotein cholesterol(LDL-C/HDL-C)and cystatin C(CysC)in the severe group were higher than those in the mild group.The level of β2-microglobulin(β2-MG)was lower than that in the mild group(P<0.05).ANGPTL3,ox-LDL,and CRP/ALB in the severe group were higher than those in the mild group(all P<0.05).Multivariate logistic regression analysis found that CysC,ANGPTL3,ox-LDL,and CRP/ALB were influencing factors of coronary artery lesions in patients with CHD(all P<0.05).Spearman correlation analysis results showed that serum ANGPTL3,ox-LDL,and CRP/ALB were positively correlated with Gensini score(all P<0.05).When predicting the degree of coronary artery disease in CHD patients with serum ANGPTL3,ox-LDL,and CRP/ALB,the AUC value of ANGPTL3 was the highest at 0.986,with sensitivity and specificity of 96.87%and 96.39%,respectively.The AUC value of ox-LDL was the lowest at 0.678,with sensitivity and specificity of 56.25%and 75.90%,respectively.The ROC curves of the three indicators showed significant differences(P<0.05).Conclusion Serum ANGPTL3,ox-LDL,and CRP/ALB are positively correlated with coronary artery lesions in patients with CHD.And ANGPTL3 has the best predictive power for the severity of coronary artery disease in patients.In clinical practice,ANGPTL3 can be prioritized and combined with ox-LDL and CRP/ALB to determine the severity of coronary artery disease in CHD.

Coronary heart diseaseCoronary artery lesionAngiopoietin-like 3Oxidized low-density lipoproteinC-reactive proteinAlbumin

余红玲、袁洪萍

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中部战区总医院第五派驻门诊部内科,武汉 430000

中部战区总医院第四派驻门诊部内科,武汉 430035

冠心病 冠状动脉病变 血管生成素蛋白3 氧化低密度脂蛋白 C反应蛋白 白蛋白

2024

中国分子心脏病学杂志
中国医学科学院,中国协和医学院

中国分子心脏病学杂志

CSTPCD
影响因子:0.426
ISSN:1671-6272
年,卷(期):2024.24(4)