冠心病患者血清中性粒细胞明胶酶相关脂质运载蛋白的表达及其临床意义

Expression of serum NGAL in coronary heart disease patients and its clinical significance

目的:探讨冠心病患者血清中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)的表达及临床意义。方法:选取因胸闷、胸痛入住心内科患者110例,根据冠脉造影结果及临床表现分为急性冠脉综合征(ACS)组33例、稳定型心绞痛(SAP)组32例和对照组45例。比较3组间的临床资料、血清NGAL水平,分析NGAL与冠心病相关性,并观察其与冠脉病变支数及Gensini积分的关系。结果:ACS组、SAP组血清NGAL水平均明显高于对照组(P<0.05),ACS组血清NGAL水平明显高于SAP组(P<0.05)。随着冠脉病变支数增加,冠心病患者血清NGAL水平增高(F=17.468,P<0.05),且与Gensini积分呈正相关(r=0.327,P<0.01)。简单及偏相关分析均显示,血清NGAL水平与冠心病呈正相关性;多因素Logistic回归分析显示,NGAL是冠心病发生的独立危险因素(OR=1.059,P<0.01)。结论:NGAL不仅能对粥样斑块稳定性具有提示性,且与冠脉病变程度呈正相关,可作为冠心病发生的独立危险因素。

Objective： To investigate the expression of serum neutrophil gelatinase-associated lipocalin （NGAL） in patients with coronary heart disease （CHD）, and to evaluate its clinical value. Methods： A total of 110 enrolled patients were divided into acute coronary syndrome （ACS） group （33 cases）, stable angina pectoris （SAP） group （32 cases） and control group （45 cases） according to the clinical manifestation and angiographic results. Serum NGAL levels measured by enzyme linked immunosorbent assay （ELISA） were compared among the groups. The correlation between serum NGAL level and CHD was analyzed. The association of NGAL with the number of diseased vessels and Gensini score were studied. Results： The serum NGAL levels in ACS group and SAP group were higher than that in control group （P 〈 0.05 ）. And serum NGAL level was significantly higher in ACS group compared to SAP group （ P 〈 0.05 ）. Statistically significant correlations were observed between NGAL level and the number of diseased vessels （ F = 17. 468, P 〈 0.05 ） and Gensini score （ r = 0. 327, P 〈 0.01 ）. Simple and partial correlation analysis showed that serum NGAL level was positively correlated with CHD. In addition, multivariate logistic regression analysis revealed that NGAL was an independent risk factor of CHD （ OR = 1. 059, P 〈 0.01 ）. Conclusion： Serum NGAL level was positively correlated with atherosclerotic plaque stability and coronary lesions severity in patients with CHD. NGAL may serve as an independent risk factor of CHD.