血浆β2微球蛋白浓度与急性冠脉综合征患者冠状动脉病变严重程度的关系

Relationship between plasma concentration of β2-microglobulin and the severity of coronary lesions in patients with acute coronary syndrome

目的探讨血浆β2微球蛋白(β2-microglobulin,β2-MG)浓度与急性冠状动脉(冠脉)综合征(acute coronary syndrome,ACS)患者冠状动脉病变严重程度的关系。方法选取2014年7月至2015年7月荆门市第二人民医院收治的496例ACS患者作为研究对象。所有患者行血浆β2-MG浓度检测,以四分位法分为第1组(n=120)、第2组(n=154)、第3组(n=132)、第4组(n=90)。根据冠脉造影检查结果评价冠脉病变严重程度,包括Gensini积分、病变血管支数及3支冠脉病变比例,分析β2-MG和冠脉病变严重程度指标之间的关系。结果4组的Gensini积分、病变血管支数及3支冠脉病变比例比较,差异具有统计学意义(P<0.05),其中第四组最高。Pearson相关分析结果显示:血浆β2-MG浓度与Gensini积分、病变血管支数及3支冠脉病变比例呈正相关(r=0.602、0.612、0.683,均P<0.05)。在校正各项混杂因素后,多因素Logistic回归分析显示:β2-MG是Gensini积分、病变血管支数及3支冠脉病变比例的独立危险因素。结论血浆β2-MG浓度是ACS患者冠脉病变严重程度的独立危险因素,随着血浆β2-MG浓度的升高,冠脉病变严重程度逐渐加重。

Objectives To investigate the relationship between plasma concentration of β2-microglobulin（β2-MG）and the severity of coronary lesions in patients with acute coronary syndrome（ACS）. Methods Totally 496 patients with ACS were selected from July 2014 to July 2015 in The Second People ＇s Hospital of Jingmen. The patients were divided into 4 groups according to the quartiles of plasma concentration of β2-MG ： the first group（n=120）, the second group（n=154）, the third group（n=132）, the fourth group（n=90）. The severity of coronary lesions was evaluated according to the results of coronary angiographic examination, including Gensini score, lesion vessel number and triple vessel coronary artery disease proportion. Relationship between plasma concentration of β2-MG and the severity of coronary lesion was analyzed. Results Gensini score, lesion vessel number and triple vessel coronary artery disease proportion among the 4 groups had statistically significant differences（P〈0.05）, and they were the highest in the fourth group.Pearson correlation analysis showed that the plasma concentration of β2-MG was positively correlated with Gensini score, lesion vessel number and triple vessel coronary artery disease proportion（r =0.602, 0.612, 0.683, P〈0.05）.After adjusting confounding factors, multi-factor logistic regression analysis showed that plasma concentration of β2-MG was an independent risk factor of lesion vessel number and triple vessel coronary artery disease proportion.Conclusions Plasma concentration of β2-MG is an independent risk factor for the severity of the coronary artery lesions in patients with ACS. With the elevation of plasma concentration of β2-MG, the severity of coronary artery lesion gradually increases.