外周血单个核细胞Cx37、AIM2、Cx43对冠心病的预测价值分析

Predictive value of peripheral blood mononuclear cell Cx37,AIM2 and Cx43 in coronary heart disease

目的探讨外周血单个核细胞缝隙连接蛋白37(Cx37)、黑色素瘤缺乏因子2(AIM2)、缝隙连接蛋白43(Cx43)对冠心病的预测价值。方法选取2019年1月至2023年10月该院收治的460例因“疑似冠心病或者胸闷、胸痛待查”而入院拟择期行冠状动脉造影(CAG)的患者作为研究对象,根据CAG检查结果分为冠心病组(212例)和非冠心病(248例)。比较两组临床特征及外周血单个核细胞Cx37、AIM2、Cx43,并予以多因素Logistic回归分析冠心病发生的危险因素,采用受试者工作特征(ROC)曲线分析外周血单个核细胞Cx37、AIM2、Cx43对冠心病的预测价值。结果冠心病组年龄、体质量指数大于非冠心病组(P<0.05),心率、血清糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)水平高于非冠心病组(P<0.05),吸烟、高血压、高脂血症、冠心病家族史的患者占比高于非冠心病组(P<0.05),血清高密度脂蛋白胆固醇(HDL-C)水平低于非冠心病组(P<0.05)。冠心病组外周血单个核细胞Cx37、Cx43表达水平低于非冠心病组,外周血单个核细胞AIM2表达水平高于非冠心病组(P<0.05)。多因素Logistic回归分析结果显示,吸烟,高血压,高脂血症,冠心病家族史,外周血单个核细胞Cx37、Cx43表达水平降低,外周血单个核细胞AIM2表达水平升高是冠心病发生的独立危险因素(OR=2.568、2.375、3.313、2.713、0.647、0.464、2.995,P<0.05)。ROC曲线分析结果显示,外周血单个核细胞Cx37、AIM2、Cx43及3项联合检测预测冠心病的曲线下面积(AUC)分别为0.712、0.732、0.708、0.922,灵敏度分别为66.51%、70.28%、71.70%、89.15%,特异度分别为69.76%、70.16%、69.35%、82.26%,其中联合检测的AUC最大(P<0.05)。结论外周血单个核细胞Cx37、AIM2、Cx43对冠心病发生具有一定的预测价值,其中联合检测的预测价值最高。

Objective To investigate the predictive value of peripheral blood mononuclear cell connexin 37(Cx37),absent in melanoma 2(AIM2)and connexin 43(Cx43)in coronary heart disease(CHD).Methods A total of 460 patients admitted to the hospital from January 2019 to October 2023 with suspected CHD or unexplained chest tightness and chest pain and scheduled for coronary angiography(CAG)were selected as the study subjects.Patients were divided into the CHD group(212 cases)and the non-CHD group(248 cases)according to the results of the CAG.The clinical characteristics and levels of peripheral blood mononuclear cell Cx37,AIM2,Cx43 were compared between the two groups.Multivariate Logistic regression analysis was performed to identify the risk factors for CHD,and the predictive value of peripheral blood mononuclear cell Cx37,AIM2 and Cx43 for CHD was assessed by receiver operating characteristic(ROC)curve.Results The age and body mass index of the CHD group were higher than those of the non-CHD group(P<0.05),the heart rate,serum glycosylated hemoglobin(HbA1c)and fasting insulin(FINS)levels were higher than those of the non-CHD group(P<0.05).The proportions of patients who smoked or hypertension,hyperlipidemia,or had a family history of CHD were higher than those of the non-CHD group(P<0.05),and the serum high-density lipoprotein cholesterol(HDL-C)level was lower than that of the non-CHD group(P<0.05).The expression levels of Cx37 and Cx43 in peripheral blood mononuclear cells in the CHD group were lower than those of the non-CHD group(P<0.05),and the expression level of AIM2 in peripheral blood mononuclear cells was higher than that of the non-CHD group(P<0.05).The results of multivariate Logistic regression analysis showed that smoking,hypertension,hyperlipidemia,family history of CHD,lower expression levels of Cx37 and Cx43,and higher expression level of AIM2 in peripheral blood single nucleated cells were the independent risk factors for the development of CHD(OR=2.568,2.375,3.313,2.713,0.647,0.464,2.995,P<0.05).ROC curve analysis showed that the area under the curve(AUC)for the prediction of CHD by peripheral blood mononuclear cells Cx37,AIM2,Cx43 and combined detection were 0.712,0.732,0.708,0.922,with sensitivity of 66.51%,70.28%,71.70%,89.15%,and specificity of 69.76%,70.16%,69.35%,82.26%,respectively.Among them,the AUC of combined detection was the highest(P<0.05).Conclusion Peripheral blood mononuclear cell markers Cx37,AIM2 and Cx43 have predictive value for the occurrence of CHD,with combined detection offering the highest predictive value.