多种动脉粥样硬化细胞因子与冠状动脉狭窄的相关性方程的建立及临床意义

The establishment of equation and clinical significant between variety of atherosclerosis cytokines and coronary artery stenosis

目的探讨多种动脉粥样硬化细胞因子与冠状动脉粥样硬化性狭窄程度的相关性,以及可能的回归方程模型。方法将198例行冠状动脉造影的患者按造影结果 Gensini积分分为冠脉狭窄轻度组(0-12分,64人)、中度组(13-34分,54人)、重度组(>34分,32人)和冠脉正常对照组48人;采用单因素方差分析探讨冠脉狭窄组与对照组及不同狭窄组间临床基线资料、一般生化指标和细胞因子的差异,采用二元或多因素Logistic逐步回归方法探讨冠状动脉粥样硬化性狭窄与多种细胞因子的相关性,及建立回归方程模型。结果冠状动脉粥样硬化性狭窄组与对照组在性别、年龄、吸烟、高密度脂蛋白胆固醇、载脂蛋白A及细胞因子IGF-1、CTGF、Ox-LDL、TGF-β1、Lp-PLA2、sICAM-1、MMP-9、MPO、HSP-70比较有统计学意义;冠脉狭窄轻度组、中度组和重度组单因素分析显示:性别、吸烟、IGF-1、CTGF、Ox-LDL、TGF-β1、Lp-PLA2、sICAM-1和MMP-9组间差异有统计学意义;多因素Logistic回归分析建立冠状动脉狭窄程度评估模型:Gensini积分=12.806+0.05CTGF+0.199Lp-PLA2+0.139Ox-LDL+0.011TGF-β1(G=15.589,P=0.009)。结论冠状动脉粥样硬化性狭窄是一个多因素相互作用的结果,检测Lp-PLA2、Ox-LDL、TGF-β1和CTGF因子血清水平,通过回归方程模型可以更高效的诊断冠状动脉狭窄及评估冠脉狭窄严重程度。

Objective To investigate the establishment of equation and clinical significant between variety of atherosclerosis cytokines and coronary artery stenosisMethods One hundred and ninety eight patients were divided into coronary artery stenosis light group（0-12 points,64）,median stenosis group（13-34 points,54）,heavey stenosis group（〉34 points,32） and normal control group （n = 48）according to their Gensini score. The basic Clinical and laboratory data were analyzed by one-way ANOVA and multivariate logistic regression analysis. Results Male,age and smoking were more prevalent in the group with coronary stenosis compared to the control group. The levels of low density lipoprotein,apolipoproteinA,high density lipoprotein,lipoprotein alpha,IGF-1,CTGF,Ox-LDL,TGF-β1, Lp-PLA2, slCAM-1, MMP-9,MPO,HSP-70 were also different in the group of coronary stenosis than control. IGF-1,CTGF,Ox-LDL,TGF- β1 ,Lp-PLA2 ,slCAM-1 and MMP-9 were different in coronary artery stenosis subgroup according to AVONA. The equation model of 12. 806＋0.05CTGF＋0. 199Lp-PLAz ＋0. 139Ox-LDL＋0. 011TGF-β1（G= 15. 589,P=0. 009） was established. Conclusion Variety of cytokines interaction lead to coronary artery stenosis,The serum levels of Lp-PLA2 ,ox-LDL,TGF-β1 and CTGF can be more elective diagnose of coronary stenosis and severe degree by equation model.