γ-谷氨酰转肽酶对冠状动脉狭窄程度的预测作用

To Predict the Severity of Coronary Artery Stenosis by γ-glutamyl transpeptidase level

目的研究γ-谷氨酰转肽酶（GGT）与冠状动脉狭窄程度的关系,探讨GGT对冠心病患者冠状动脉病变严重程度的预测作用。方法 584例患者行冠状动脉造影后对其确诊冠心病的（464例）及非冠心病（120例）进行冠脉Gensini评分,并将其分为低分组（Gensini积分〈30分,n=342例）和高分组（≥30分,n=242）,检测血清GGT水平,应用SPSS19.0软件进行统计分析。结果冠心病患者血清GGT水平高于非冠心病患者（P〈0.001）。根据冠脉Gensini积分将患者分组后,高分组GGT水平高于低分组（P〈0.001）,相关性分析显示GGT水平与Gensini积分呈正相关（r=0.265,P〈0.001）,多因素Logistic回归分析显示,高GGT水平和高龄、男性、低HDL水平是高Gensini积分的独立危险因素。受试者工作特征曲线（ROC曲线）显示GGT的曲线下面积是0.665（95%CI：0.621～0.709）,当GGT诊断临界值取22.50 U/L时,其诊断效率最高,敏感性为83.6%,特异性为48.2%。结论 GGT与冠心病严重程度有相关性,在临床上可作为预测冠状动脉狭窄程度的指标。

Objective The aim of this study is to investigate the association betweenγ glutamyl transpeptidase（GGT）and the severi-ty of coronary artery stenosis.Methods According to the results of coronary angiography,a total of 464 patients with coronary artery disease（CAD）were divided into 2 groups by Gensini scores,the low score group（n=342）and the high score group（n=242）one hundred and twenty patients without CAD were asnon CAD group.Results The GGT was higher in CAD group compared with non CAD groups（P〈0.05）.At the same time,The GGT was higher in the high score group compared with the low score group（P〈0.05）. A cut off value was 22.50 for GGT prediction of high Gensini score with a sensitivity and specificity of 83.6% and 48.2%,respectively. After multivariate analysis,high levels of GGT were independent predictors of high Gensini score together with age and high density lipoprotein.Conclusion Our study suggests that the GGT is a independent predictors of CAD that may be useful for predict the se-verity of coronary artery stenosis.