毛从答,李玲玲,牛兆青,张海茂.冠状动脉狭窄早期诊断及分级的血液指标分析[J].中南民族大学学报自然科学版,2022,41(1):38-43
冠状动脉狭窄早期诊断及分级的血液指标分析
Analysis of blood indexes for early diagnosis and classification of coronary artery stenosis
  
DOI:10.12130/znmdzk.20220107
中文关键词: 小而密低密度脂蛋白  血浆总脂联素  高分子脂联素  冠状动脉狭窄  早期诊断  严重程度分级
英文关键词: small and dense low-density lipoprotein  total plasma adiponectin  high molecular adiponectin  coronary artery stenosis disease  early diagnosis  severity classification
基金项目:青岛市卫健委西医科研资助项目 (2019-WJZD122)
作者单位
毛从答 青岛市胶州中心医院 检验科胶州 266300 
李玲玲 青岛市胶州中心医院 检验科胶州 266300 
牛兆青 青岛市胶州中心医院 检验科胶州 266300 
张海茂 青岛市中心医院 检验科青岛 266042 
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中文摘要:
      为评价血液指标对冠状动脉狭窄早期诊断及分级的价值,选择冠状动脉狭窄患者125例(观察组)及同期健康体检者125例(对照组)进行了研究. 检测了两组小而密低密度脂蛋白(small and dense low-density lipoprotein, sd-LDL)、血浆总脂联素、高分子脂联素的水平.比较两组各血液指标,采用Gensini评分对冠状动脉狭窄进行分级,分析了不同分级患者各指标.结果表明:观察组血浆总脂联素、高分子脂联素水平均显著低于对照组(P<0.05),观察组sd-LDL高于对照组(P<0.05).血浆总脂联素、高分子脂联素均为轻度病变组>中度病变者>重度病变组,sd-LDL为轻度病变组<中度病变者<重度病变组(P<0.05).冠状动脉狭窄患者血浆总脂联素、高分子脂联素水平与总Gensini评分均呈显著的负相关关系,sd-LDL与总Gensini评分呈正相关关系(P<0.05).ROC分析结果显示:sd-LDL、血浆总脂联素、高分子脂联素对冠状动脉狭窄早期诊断的截断值分别为0.545、12.235、5.445 mg/L;曲线下面积(AUC)分别为0.724、0.751、0.759.三者联合诊断的AUC为0.931,其诊断效能高于各指标单独(P<0.05).说明sd-LDL、血浆总脂联素、高分子脂联素与冠状动脉狭窄严重程度分级相关,且上述指标可用于冠状动脉狭窄的早期诊断.
英文摘要:
      In order to evaluate the value of blood indexes in early diagnosis and grading of coronary artery stenosis, 125 patients with coronary artery stenosis (observation group) and 125 healthy people (control group) were selected for the study. The levels of small and dense low-density lipoprotein (sd-LDL), plasma total adiponectin and high molecular adiponectin were detected in both groups. The blood indexes of the two groups were compared, the Gensini score was used to grade the coronary artery stenosis, and the indicators of patients in different groups were analyzed. The results showed that the plasma levels of total adiponectin and polymer adiponectin in the observation group were significantly lower than those in the control group (P<0.05), and the sd-LDL level in observation group was higher than that in the control group (P<0.05). Plasma total adiponectin and high molecular weight adiponectin level varied from high to low following the order of mild, moderate and severe disease groups; while sd-LDL level varied from low to high following the same order (P<0.05). The levels of plasma total adiponectin and high molecular adiponectin in patients with coronary artery stenosis were negatively correlated with the total Gensini score, and sd-LDL was positively correlated with the total Gensini score (P<0.05). ROC analysis results showed that the cut-off values of sd-LDL, plasma total adiponectin, and polymer adiponectin for early diagnosis of coronary artery stenosis were 0.545, 12.235, 5.445 mg/L, and the areas under the AUC curve were 0.724, 0.751, 0.759, respectively. The AUC of the three combined diagnosis was 0.931, and its diagnostic efficiency was higher than that of each index alone (P<0.05). It is shown that sd-LDL, plasma total adiponectin, and high molecular adiponectin are related to the severity of coronary artery stenosis, and can be used for the early diagnosis of coronary artery stenosis.
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