小而密低密度脂蛋白、血浆总脂联素、高分子脂联素对冠状动脉狭窄早期诊断及冠状动脉狭窄严重程度分级作用研究
Study on the effects of small and dense low-density lipoprotein, plasma total adiponectin, and high molecular adiponectin on early diagnosis of coronary artery stenosis and severity of coronary artery stenosis
投稿时间:2021-01-02  修订日期:2021-02-15
DOI:
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 Heart Disease  Early Diagnosis  Severity Classification
基金项目:
作者单位E-mail
毛从答 青岛市胶州中心医院 duncuo26706@163.com 
李玲玲 青岛市胶州中心医院  
牛兆青 青岛市胶州中心医院  
张海茂 青岛市中心医院  
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中文摘要:
      目的:探讨小而密低密度脂蛋白、血浆总脂联素、高分子脂联素对冠状动脉狭窄早期诊断及冠状动脉狭窄严重程度分级作用。方法:选择2018年2月至2019年10月在我院接受治疗的冠状动脉狭窄患者125例(观察组)及同期健康体检者125例(对照组)进行研究。2组均采集空腹外周静脉血5ml对小而密低密度脂蛋白(small dense Low Density Lipoprotein,sd-LDL)、血浆总脂联素、高分子脂联素水平进行检测,比较2组sd-LDL、血浆总脂联素、高分子脂联素水平。采用Gensini评分对冠状动脉狭窄严重程度进行分级,分析不同严重程度患者各指标,并进行相关性分析,以ROC法判断各指标对冠心病早期诊断效能。结果: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)。不同冠状动脉狭窄严重程度患者sd-LDL、血浆总脂联素、高分子脂联素水平差异具有统计学意义,且血浆总脂联素、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轻度病变组<中度病变者<重度病变组(P<0.05)。相关性分析结果显示: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(r=-0.795,-0.707,P=0.014,0.019),sd-LDL与总Gensini评分呈正相关关系(r=0.605,P=0.002)。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0.545mmol/L、12.235mg/L、5.445mg/L;曲线下面积(AUC)分别为0.724、0.751、0.759。三者联合诊断(指sd-LDL、血浆总脂联素或高分子脂联素联合检测时其中1个指标低于截断值即判断为冠状动脉狭窄)的AUC为0.931,其诊断效能高于各指标单独(Z=5.815、5.277、5.942,均P<0.05)。结论:sd-LDL、血浆总脂联素、高分子脂联素可用于冠状动脉狭窄早期诊断及冠状动脉狭窄严重程度分级,且各指标联合检测有助于提高冠心病早期诊断效能。
英文摘要:
      Objective: To explore the effects of small and dense low-density lipoprotein, plasma total adiponectin, and high molecular adiponectin on the early diagnosis of coronary artery stenosis and the severity of coronary artery stenosis.Methods: In both groups, 5ml of fasting peripheral venous blood was collected to detect the levels of small dense Low Density Lipoprotein (sd-LDL), plasma total adiponectin, and high molecular weight adiponectin. Compare the two groups of sd-LDL , Plasma total adiponectin, high polymer adiponectin levels.Gensini score was used to classify the severity of coronary artery disease, and the indicators of patients with different severity were analyzed, and correlation analysis was performed. The ROC method was used to judge the efficacy of each indicator in the early diagnosis of coronary heart disease.Results: The plasma levels of total adiponectin and high molecular adiponectin in the observation group were significantly lower than those in the control group (P<.0.05), and the sd-LDL in the observation group was higher than that in the control group (P<0.05). There are statistically significant differences in the levels of sd-LDL, plasma total adiponectin, and high polymer adiponectin in patients with different severity of coronary artery stenosis, and plasma total adiponectin and high polymer adiponectin are in the mildly diseased group> moderate Patients with disease>severe disease group, sd-LDL mild disease group
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