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冠心病患者半乳糖凝集素-3與冠脈病變程度及預(yù)后的相關(guān)性研究

發(fā)布時(shí)間:2018-08-18 16:28
【摘要】:目的:通過檢測(cè)冠心病患者血清半乳糖凝集素-3(Galectin-3)水平,分析其在不同類型冠心病患者中的水平及分別與Gensini積分、B型腦鈉肽(BNP)的相關(guān)性,并觀察其與冠心病患者主要心血管事件(MACE)發(fā)生的關(guān)系,初步探討冠心病患者血清Galectin-3水平與冠狀動(dòng)脈病變程度及預(yù)后關(guān)系。方法:收集我院自2013年7月至2014年3月因胸痛于我科住院診治,根據(jù)臨床表現(xiàn)、心電圖、心肌酶或冠狀動(dòng)脈造影(CAG)結(jié)果確診為冠心病(CAD)的患者。從上述CAD患者中隨機(jī)選取40例穩(wěn)定性心絞痛(SA)患者作為A組,40例不穩(wěn)定性心絞痛(UA)患者作為B組,40例急性心肌梗死(AMI)患者作為C組,共120例。收集我院體檢中心行健康查體的40位健康者作為正常對(duì)照組(D組)。應(yīng)用酶聯(lián)免疫吸附法(ELISA)檢測(cè)所有研究對(duì)象的血清Galectin-3水平,化學(xué)發(fā)光法檢測(cè)BNP水平。冠脈狹窄程度采用用Gensini積分系統(tǒng)進(jìn)行估測(cè)。對(duì)120例CAD患者進(jìn)行1年的隨訪,記錄隨訪期間發(fā)生的MACE。結(jié)果:1.CAD患者血清Galectin-3水平高于正常對(duì)照組,且C組患者血清Galectin-3水平高于B組,B組患者血清Galectin-3水平高于A組,除B組與C組患者血清Galectin-3水平無統(tǒng)計(jì)學(xué)差異(p=0.197)外,其它各組間均有統(tǒng)計(jì)學(xué)顯著性差異(p0.01)。2.Spearman相關(guān)分析表明,Galectin-3與Gensini評(píng)分、BNP呈正相關(guān)。3.隨訪1年,15例患者出現(xiàn)MACE。與無不良心血管事件組相比,有心血管不良事件組患者血清Galectin-3水平顯著升高,統(tǒng)計(jì)學(xué)有顯著性差異(p0.05)4.多因素Logistic回歸分析表明,冠心病患者血清Galectin-3 (OR=1.157, CI:1.047-1.279,p0.01)、BNP(OR=1.010,CI: 1.000-1.034,p0.028)水平與其不良預(yù)后呈正相關(guān)。結(jié)論:1.冠心病患者血清Galectin-3水平可能與AS的形成斑塊不穩(wěn)定性相關(guān)。2.冠心病患者血清Galectin-3水平與冠狀動(dòng)脈病變嚴(yán)重程度呈正相關(guān)。3.Galectin-3可能促進(jìn)冠狀動(dòng)脈粥樣硬化的發(fā)生、發(fā)展及心室重塑。4.血清Galectin-3水平高的CAD患者可能預(yù)后不良。
[Abstract]:Objective: to detect the level of serum galactose agglutinin 3 (Galectin-3) in patients with coronary heart disease (CHD) and its correlation with Gensini integral type B brain natriuretic peptide (BNP). The relationship between serum Galectin-3 level and the severity and prognosis of coronary artery disease (CHD) was investigated by observing the relationship between serum Galectin-3 level and the occurrence of main cardiovascular events (MACE) in patients with coronary heart disease (CHD). Methods: from July 2013 to March 2014, patients with coronary heart disease (CAD) were diagnosed as coronary heart disease (CHD) according to clinical manifestation, electrocardiogram (ECG), myocardial enzyme or coronary angiography (CAG). Forty patients with stable angina pectoris (SA) were randomly selected as group A and 40 patients with unstable angina pectoris (UA) as group B and 40 patients with acute myocardial infarction (AMI) as group C. A total of 40 healthy subjects were collected from our physical examination center as the normal control group (group D). Enzyme linked immunosorbent assay (ELISA) was used to detect the level of serum Galectin-3 and chemiluminescence to detect the level of BNP. The degree of coronary stenosis was estimated by Gensini integral system. 120 patients with CAD were followed up for 1 year. Results 1. The level of serum Galectin-3 in patients with CAD was higher than that in normal controls, and the level of serum Galectin-3 in group C was higher than that in group B (P < 0. 197). The level of serum Galectin-3 in group B was higher than that in group A (P < 0. 197). 2. Spearman correlation analysis showed that Galectin-3 was positively correlated with Gensini score. 15 patients were followed up for 1 year. Compared with the non-adverse cardiovascular events group, the serum Galectin-3 level of the patients with cardiovascular adverse events was significantly higher than that of the non-adverse cardiovascular events group (p0.05) 4. Multivariate Logistic regression analysis showed that the level of serum Galectin-3 (OR 1.157, CI: 1.047-1.279 / p0.01) was positively correlated with the poor prognosis in patients with coronary heart disease (OR 1.010 CI: 1.000-1.034 P 0.028). Conclusion 1. The serum Galectin-3 level in patients with coronary heart disease may be related to plaque instability. 2. 2. The level of serum Galectin-3 was positively correlated with the severity of coronary artery disease. 3. Galectin-3 may promote the occurrence, development and ventricular remodeling of coronary atherosclerosis. CAD patients with high serum Galectin-3 level may have poor prognosis.
【學(xué)位授予單位】:濱州醫(yī)學(xué)院
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2015
【分類號(hào)】:R541.4

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