發(fā)布時(shí)間：2018-09-12 05:03

【摘要】：目的：探討血清羧化不全骨鈣素水平與冠心病的類(lèi)型、冠狀動(dòng)脈病變程度的關(guān)系,以及血清羧化不全骨鈣素水平是否是冠心病的獨(dú)立危險(xiǎn)因素。方法：選擇行冠狀動(dòng)脈造影的180例患者作為研究對(duì)象。收集患者病史資料,一般資料包括：年齡、性別、糖尿病史、高血壓史、吸煙史、飲酒史。實(shí)驗(yàn)室資料包括：血清羧化不全骨鈣素、血脂、血糖等。臨床指標(biāo)：收縮壓、舒張壓、冠狀動(dòng)脈造影及超聲心動(dòng)圖。根據(jù)冠狀動(dòng)脈造影結(jié)果分為：冠心病組140例和正常對(duì)照組40例。比較上述兩組間臨床指標(biāo)的差別。根據(jù)冠心病類(lèi)型將冠心病組分為：急性心肌梗死(AMI)、不穩(wěn)定型心絞痛(UAP)、穩(wěn)定型心絞痛(SAP)三個(gè)組。同時(shí)根據(jù)病變血管支數(shù)分為單支和多支病變兩個(gè)組,分別比較各組間血清羧化不全骨鈣素水平。根據(jù)Gensini積分探討血清羧化不全骨鈣素與冠狀動(dòng)脈病變程度的相關(guān)性。對(duì)冠心病組進(jìn)行多元Logistic回歸分析,探討血清羧化不全骨鈣素是否是冠心病的獨(dú)立危險(xiǎn)因素。結(jié)果：1.血清羧化不全骨鈣素水平在冠心病組明顯低于非冠心病組[(1.02±0.35)ng/ml vs (1.32±0.51)ng/ml],差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2.血清羧化不全骨鈣素水平在SAP組、UAP組、AMI組分別為(1.22±0.38)ng/ml、(1.04±0.23)ng/ml、(0.89±0.21)ng/ml。血清羧化不全骨鈣素水平在三組間均明顯低于非冠心病組(1.32±0.51) ng/ml,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。3.血清羧化不全骨鈣素水平在正常對(duì)照組、單只、多支病變組分別為(1.32±0.51)ng/ml、(1.10±0.36)ng/ml、 (0.97±0.34) ng/ml o隨著冠脈病變支數(shù)的增加,三組間比較,血清羧化不全骨鈣素水平明顯降低。多支病變組血清羧化不全骨鈣素水平明顯低于單支病變組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。4.血清羧化不全骨鈣素水平在Gensini高積分組與Gensini低積分組分別為(0.96±0.32)ng/ml、(1.12±0.34)ng/ml,兩組間比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。5.對(duì)冠心病組進(jìn)行多元Logistic回歸分析,結(jié)果認(rèn)為收縮壓、TC、TG、LDL-C、低血清羧化不全骨鈣素水平是冠心病的獨(dú)立危險(xiǎn)因素。結(jié)論：1.血清羧化不全骨鈣素水平與冠心病的類(lèi)型及其冠狀動(dòng)脈病變程度密切相關(guān)。2.低血清羧化不全骨鈣素水平是冠心病的獨(dú)立危險(xiǎn)因素,并可用于臨床冠心病危險(xiǎn)人群的及早發(fā)現(xiàn)。
[Abstract]:Objective: to investigate the relationship between serum carboxylation of incomplete osteocalcin and the type of coronary artery disease and the degree of coronary artery disease, and whether serum carboxylated incomplete osteocalcin level is an independent risk factor for coronary heart disease. Methods: 180 patients undergoing coronary angiography were selected as study objects. Collect patient history data, general data include: age, gender, diabetes history, hypertension history, smoking history, alcohol history. Laboratory data include: serum carboxylation incomplete osteocalcin, blood lipids, blood sugar and so on. Clinical parameters: systolic blood pressure, diastolic blood pressure, coronary angiography and echocardiography. According to the results of coronary angiography, 140 cases in coronary heart disease group and 40 cases in normal control group were divided into two groups. To compare the difference of clinical indexes between the two groups. According to the type of coronary heart disease, coronary heart disease group was divided into three groups: acute myocardial infarction (AMI), unstable angina pectoris (UAP), stable angina pectoris (SAP). At the same time, according to the number of vessel branches, they were divided into two groups: single vessel group and multi-vessel lesion group. The serum carboxylation incomplete osteocalcin levels were compared among each group. To investigate the correlation between serum carboxylated osteocalcin and severity of coronary artery disease according to Gensini score. Multivariate Logistic regression analysis was performed to determine whether serum carboxylation of osteocalcin was an independent risk factor for coronary heart disease (CHD). The result is 1: 1. The level of serum carboxylation incomplete osteocalcin in coronary heart disease group was significantly lower than that in non-coronary heart disease group [(1.02 鹵0.35) ng/ml vs (1.32 鹵0.51) ng/ml], the difference was statistically significant (P0.05) .2. Serum carboxylated osteocalcin levels in SAP group were (1.22 鹵0.38) ng/ml, (1.04 鹵0.23) ng/ml, (0.89 鹵0.21) ng/ml., respectively. Serum carboxylation incomplete osteocalcin levels in the three groups were significantly lower than that in the non-coronary heart disease group (1.32 鹵0.51) ng/ml, difference was statistically significant (P0.05) .3. The serum carboxylation incomplete osteocalcin levels were (1.32 鹵0.51) ng/ml, (1.10 鹵0.36) ng/ml, (0.97 鹵0.34) ng/ml o in normal control group, (1.32 鹵0.51) ng/ml, in single group and (0.97 鹵0.34) ng/ml o in multivessel lesion group. The serum level of osteocalcin in multivessel lesion group was significantly lower than that in single vessel lesion group (P0.05). 4. Serum carboxylation incomplete osteocalcin levels were (0.96 鹵0.32) ng/ml, (1.12 鹵0.34) ng/ml, in Gensini high score group and (0.96 鹵0.32) ng/ml, in Gensini low score group, the difference was statistically significant (P0.05). Multivariate Logistic regression analysis was performed in patients with coronary heart disease. The results showed that the low serum carboxylation incomplete osteocalcin level was an independent risk factor for coronary heart disease. Conclusion 1. The level of serum carboxylation incomplete osteocalcin was closely related to the type of coronary heart disease and the severity of coronary artery disease. Low serum carboxylation incomplete osteocalcin level is an independent risk factor for coronary heart disease and can be used for early detection of clinical coronary heart disease risk population.
【學(xué)位授予單位】：湖南師范大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R541.4

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