冠心病患者血清软骨寡聚基质蛋白水平变化及其与冠状动脉钙化的关系

Changes of serum COMP level and its the relationship with coronary artery calcification in patients with CHD

目的:探讨冠心病(CHD)患者血清软骨寡聚基质蛋白(COMP)水平变化及其与冠状动脉钙化的关系。方法:选择在医院就诊的237例CHD患者,将其纳入观察组,同时抽取237名健康体检者纳入对照组。收集两组受试者一般资料、血清COMP水平。观察组患者同时检测血脂、同型半胱氨酸(Hcy)、白细胞(WBC)、C反应蛋白(CRP)水平和冠状动脉钙化积分(CACS),观察CHD患者一般资料、血清学指标与冠状动脉明显钙化的相关性。结果:对照组受试者COMP水平为(111.74±21.86)ng/ml,观察组患者COMP水平为(162.74±22.61)ng/ml,两组比较差异有统计学意义(t=19.082,P<0.001)。观察组中明显钙化患者COMP水平显著高于无明显钙化患者,其差异有统计学意义(t=8.719,P<0.001)。COMP预测明显冠状动脉钙化患者的最佳截断值为157.2 ng/ml,预测的灵敏度为73.5%,特异度为86.6%,明显冠状动脉钙化患者的受试者工作(ROC)曲线下面积(AUC)为0.85,95%置信区间(95%CI)为0.806~0.905。多因素Logistic分析,年龄、吸烟、糖尿病、CRP和COMP水平为冠状动脉钙化的独立影响因素(OR=5.857,OR=2.688,OR=3.684,OR=1.082,OR=4.639;P<0.05)。结论:冠心病患者COMP水平高于正常人群,是CHD患者冠状动脉钙化的独立危险因素,预测冠状动脉明显钙化具有中等偏上价值。

Objective： To explore the changes of serum cartilage oligomeric matrix[Abstract] Objective： To explore the changes of serum cartilage oligomeric matrix protein （COMP） level of patients with coronary heart disease （CHD） and the relationship between the changes and coronary artery calcification. Methods： 237 patients with CHD were divided into the observation group, and 237 persons who underwent healthy physical examination were divided into control group at the same time. The general data of the two groups and the serum COMP level were collected. The level of blood lipid, homocysteine （Hcy）, white blood cell, C reactive protein （CRP） and coronary artery calcification score （CACS） of observation group were simultaneously detected at the same time. The correlation between the general data of the patients with CHD and the significant calcification of the coronary artery, and between the serological index and the significant calcification of the coronary artery were observed, respectively. Results： The difference of COMP level between control group （111.74＋21.86 ng/mL） and observation group （162.74＋22.61 ng/mL） was significant （t=19.082, P〈0.001）. And in observation group, the COMP level of patients with significant calcification was significantly higher than that of patients without significant calcification （t=8.719, P〈0.001）. The optimal cutoff value of patients with significant coronary artery calcification that were predicted by COMP was 157.2ng/mL, and the sensitivity of prediction was 73.5%, and its specificity was 86.6%, and the area under curve （AUC） of receiver of curve （ROC） of them was 0.85, and the 95% confidence interval （95% CI） was 0.806-0.905. The results of multi-factor logistic analysis indicated that age, smoking, diabetes, CRP and COMP were independent factors of coronary artery calcification （OR=5.857, OR=2.688, OR=3.684, OR=1.082, OR=4.639, P〈0.05）, respectively. Conclusion： The COMP level of patients with significant coronary artery calcification that were predicted by COMP was 157.2ng/mL, and the sensitivity of prediction was 73.5%, and its specificity was 86.6%, and the area under curve （AUC） of receiver of curve （ROC） of them was 0.85, and the 95% confidence interval （95% CI） was 0.806-0.905. The results of multi-factor logistic analysis indicated that age, smoking, diabetes, CRP and COMP were independent factors of coronary artery calcification （OR=5.857, OR=2.688, OR=3.684, OR=1.082, OR=4.639, P〈0.05）, respectively. Conclusion： The COMP level of patients with CHD is higher than that of normal population, and it is an independent risk factor of coronary artery calcification of patients with CHD. Therefore, to predict the obvious calcification of coronary artery has the higher value and it has the value of clinical promotion.