本文選題：心臟標(biāo)志物　切入點(diǎn)：冠心病　出處：《重慶醫(yī)學(xué)》2016年35期 　論文類型：期刊論文

【摘要】：目的探討多種心臟標(biāo)志物與冠狀動(dòng)脈鈣化積分(CACS)的關(guān)系及其臨床診斷價(jià)值。方法選取2013年10月至2014年4月在貴州省人民醫(yī)院住院的冠心病(CHD)患者70例(疾病組)和體檢健康者50例(對(duì)照組),檢測(cè)其血清白細(xì)胞介素-10(IL-10)、妊娠相關(guān)血漿蛋白A(PAPP-A)、高遷移率族蛋白B1(HMGB1)、脂聯(lián)素(APN)、1,25二羥基維生素D3[1,25(OH)2D3]、缺氧誘導(dǎo)因子-1α(HIF-1α)、白細(xì)胞介素-18(IL-18)、基質(zhì)γ-羧基谷氨酸蛋白(MGP)及骨橋蛋白(OPN)9種標(biāo)志物水平;使用雙源CT對(duì)疾病組進(jìn)行冠狀動(dòng)脈成像檢查以計(jì)算患者CACS,并根據(jù)CACS將患者分為重度、中度、輕度患者;比較各組血清心臟標(biāo)志物水平,分析其與CACS的關(guān)系,并評(píng)價(jià)其臨床診斷價(jià)值。結(jié)果疾病組與對(duì)照組血清1,25(OH)2D3、HIF-1α、IL-18、MGP及OPN水平比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);不同CACS患者與對(duì)照組血清IL-10、PAPP-A、1,25(OH)2D3、HIF-1α、IL-18、MGP及OPN水平比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);CACS與1,25(OH)2D3呈負(fù)相關(guān)(P0.05),與HIF-1α、IL-10、MGP呈正相關(guān)(P0.05),且與1,25(OH)2D3、HIF-1α、IL-18、MGP及OPN存在明顯的線性關(guān)系(P0.05);繪制受試者工作特征(ROC)曲線顯示,HIF-1α、MGP、1,25(OH)2D3對(duì)CHD的診斷價(jià)值較高,其ROC曲線下面積分別為0.826、0.667和0.616,靈敏度分別為73.30%、58.80%、48.50%,特異度分別為73.50%、83.70%和95.80%,3項(xiàng)標(biāo)志物聯(lián)合檢測(cè)的AUC為0.845,靈敏度和特異度分別達(dá)到90.0%和70.0%。結(jié)論多項(xiàng)心臟標(biāo)志物對(duì)CHD具有較高的診斷價(jià)值,加強(qiáng)心臟標(biāo)志物與動(dòng)脈粥樣硬化及鈣化的相關(guān)性研究,有利于促進(jìn)心臟標(biāo)志物的臨床應(yīng)用。
[Abstract]:Objective to investigate the relationship between various cardiac markers and coronary artery calcification score (CACSs) and their clinical diagnostic value. Methods 70 patients with coronary heart disease (CACS) hospitalized in Guizhou Provincial people's Hospital from October 2013 to April 2014 (disease group) were selected. And 50 healthy controls (control group), serum interleukin-10 (IL-10), pregnancy-associated plasma protein (PAPP-An), high mobility group protein B1 (HMGB1), adiponectin (APNX) 25 dihydroxyvitamin D3, hypoxia inducible factor-1 偽 (HIF-1 偽), interleukin-18 (IL-18), matrix 緯 -carboxylic acid (緯 -carboxylic group). The levels of 9 markers of glutamate protein (MGP) and osteopontin (OPN); Coronary angiography was performed in the disease group with dual-source CT, and the patients were divided into severe, moderate and mild patients according to CACS. The serum cardiac markers in each group were compared, and the relationship between CACS and CACS was analyzed. Results the serum levels of IL-18 MGP and OPN in patients with different CACS and control group were significantly higher than those in control group, and the levels of IL-18 and OPN in patients with different CACS and control group were significantly higher than those in control group, and the serum levels of IL-18MGP and OPN in patients with different CACS were significantly higher than those in control group (P < 0.05), and the levels of IL-18MGP and OPN in patients with different CACS were significantly higher than those in control group (P < 0.05). The levels of IL-18MGP and OPN in serum of patients with different CACS were compared with those of control group (P < 0.05). The difference was statistically significant (P 0.05). There was a negative correlation between CACS and OH2D3 and a positive correlation with HIF-1 偽 -IL-10MGP. There was also a significant linear relationship between CACS and OPN. The diagnostic value of OHIF-1 偽 MGP-1 偽 MGP1OH2D3 was higher than that of OH2D3, and the diagnostic value of OH2D3 was higher than that of OH2D3 in diagnosis of OH2D3, the diagnostic value of OH2D3 was higher than that of OH2D3 in diagnosis of OH2D3, the diagnostic value of HIF-1 偽 was higher than that of OH2D3 in the diagnosis of OH2D3, and there was a significant linear relationship between CACS and OH2D3 in the diagnosis of CHD. The area under the ROC curve was 0.826, 0.667 and 0.616, the sensitivity was 73.30 and 58.80,48.50, and the specificity was 73.500.83.70% and 95.800.450.The sensitivity and specificity of the three markers were 90.0% and 70.00.Conclusion many cardiac markers have high diagnostic value for CHD. Strengthening the relationship between cardiac markers and atherosclerosis and calcification is helpful to promote the clinical application of cardiac markers.
【作者單位】： 貴州省人民醫(yī)院臨床檢驗(yàn)中心;貴航集團(tuán)303醫(yī)院檢驗(yàn)科;貴州省人民醫(yī)院心內(nèi)科;貴州省人民醫(yī)院放射科;
【基金】：貴州省省長(zhǎng)資金臨床應(yīng)用課題專項(xiàng)研究項(xiàng)目[黔省專合字(2012)117號(hào)]
【分類號(hào)】：R541.4;R446.1

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