外周血血小板与γ-谷氨酰转移酶对冠心病斑块稳定性的评估价值

The evaluation value of peripheral blood platelets to gamma-glutamyl transferase ratio on coronary heart disease plaques stability

目的探讨冠心病患者外周血血小板与γ-谷氨酰转移酶比值(PLT/GGT)对虚拟组织学-血管内超声(VH-IVUS)识别的斑块稳定性的评估价值。方法采用前瞻性研究的方法,纳入2020年6月至2022年12月浙江省荣军医院/嘉兴学院附属第三医院收治的冠心病患者100例,根据VH-IVUS检查的斑块稳定性分为易损斑块组42例与稳定斑块组58例;比较两组一般资料、PLT/GGT及其他实验室指标,分析冠心病患者外周血PLT/GGT与斑块稳定性的关系及PLT/GGT对患者斑块稳定性的评估价值。结果易损斑块组C反应蛋白(CRP)、γ-谷氨酰转移酶(GGT)水平高于稳定斑块组[(8.07±1.85)mg/L比(7.23±1.57)mg/L、(72.39±10.85)U/L比(67.13±8.57)U/L],PLT水平、PLT/GGT低于稳定斑块组[(180.76±11.75)×10^(9)/L比(187.36±12.47)×10^(9)/L、2.55±0.42比2.84±0.41],差异有统计学意义(P<0.05);点二列相关性分析结果显示,冠心病患者VH-IVUS识别的斑块稳定性与CRP、GGT、PLT、PLT/GGT均有关,差异有统计学意义(P<0.05);受试者工作特征曲线分析结果显示,冠心病患者外周血PLT/GGT评估斑块稳定性的曲线下面积为0.71,具有一定评估价值。结论冠心病患者外周血PLT/GGT与VH-IVUS识别的斑块稳定性密切相关,可作为评估患者斑块稳定性的有效指标。

Objective To investigate the value of peripheral blood platelet to gamma-glutamyl transferase ratio(PLT/GGT)in evaluating plaque stability recognized by virtual histology-intravascular ultrasound(VH-IVUS)in patients with coronary heart disease.Methods This study was a prospective study.A total of 100 patients with coronary heart disease admitted in Zhejiang Veteran Hospital/the Third Affiliated Hospital of Jiaxing University from June 2020 to December 2022 were included.They were divided into vulnerable plaque group(42 cases)and stable plaque group(58 cases)based on the stability of the plaque examined by VH-IVUS.The general data,PLT/GGT and other laboratory indexes were compared between the two groups.The relationship between PLT/GGT and plaque stability in peripheral blood of patients with coronary heart disease and the evaluation value of PLT/GGT on plaque stability were analyzed.Results The levels of C-reactive protein(CRP)and gamma-glutamyl transferase(GGT)in the vulnerable plaque group were higher than those in the stable plaque group:(8.07±1.85)mg/L vs.(7.23±1.57)mg/L,(72.39±10.85)U/L vs.(67.13±8.57)U/L,and PLT,PLT/GGT levels were lower than those in the stable plaque group:(180.76±11.75)×10^(9)/L vs.(187.36±12.47)×10^(9)/L,2.55±0.42 vs.2.84±0.41,the differences were statistically significant(P<0.05).Point two column correlation found that the plaque stability recognized by VH-IVUS in patients with coronary heart disease was related to CRP,GGT,PLT,PLT/GGT(P<0.05).Receiver operating characteristic curve analysis showed that the area under the curve(AUC)for assessing plaque stability using the peripheral blood PLT/GGT in patients with coronary heart disease was 0.71,which had certain evaluation value.Conclusions The peripheral blood PLT/GGT in patients with coronary heart disease is closely related to the plaque stability recognized by VH-IVUS,and can be used as an effective indicator for evaluating plaque stability in patients.