人软骨糖蛋白-39对冠状动脉侧支血管生成的影响

Influence of human cartilage glycoprotein-39 on angiogenesis of coronary collateral vessel

目的探讨血清人软骨糖蛋白-39(HCgp-39)水平对冠状动脉侧支血管(CCV)形成的影响。方法连续入选2015年1月～2017年10月于恩施州中心医院行冠状动脉造影并诊断为冠状动脉慢性完全闭塞(CTO)的患者175例为研究对象。根据Rentrop评分标准将患者的CCV分为0～3级,其中Rentrop 0级和1级的患者纳入CCV生成不良组(n=94),而Rentrop 2～3级的患者纳入CCV生成良好组(n=81)。比较两组患者的临床资料,并采用ELISA法测定血清HCgp-39水平。结果 CCV生成不良组患者的血清HCgp-39水平显著高于CCV生成不良组,差异具有统计学意义(P<0.001)。通过比较各Rentrop分级患者的资料发现,HCgp-39水平随着Rentrop分级的增加而降低。多因素Logistic回归结果表明,HCgp-39水平(OR=1.23,95%CI:1.07～1.41,P=0.003)、空腹血糖(OR=1.67,95%CI:1.10～2.54,P=0.016)和右冠状动脉CTO病变(OR=0.70,95%CI:0.51～0.96,P=0.027)是影响CCV生成的独立因素。ROC曲线分析提示,血清HCgp-39水平预测CCV生成不良的最佳截点为110.4 ng/ml,其敏感性为73%,特异性为80%。结论CTO患者的血清HCgp-39水平与其CCV的生成密切相关,HCgp-39是影响CCV生成的独立因素。

Objective To discuss the influence of human cartilage glycoprotein-39(HCgp-39)on angiogenesis of coronary collateral vessel(CCV).Methods The patients(n=175),received coronary angiography and diagnosed as coronary chronic total occlusion(CTO),were continuously chosen from Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from Jan.2015 to Oct.2017.CCV of the patients was clarified into grades 0-3 based on the Rentrop scoring system,and patients with Rentrop grades 0~1 were set into poor CCV group(n=94)and those with Rentrop grades 2~3 were set into good CCV group(n=81).The clinical data was compared between 2 groups,and level of serum HCgp-39 was determined by using ELISA.Results The level of HCgp-39 was significantly higher in poor CCV group than that in good CCV group(P<0.001).The level of HCgp-39 decreased along with the increase of Rentrop grades after compared data of patients with different Rentrop grades.The results of Logistic regression analysis showed that level of HCgp-39(OR=1.23,95%CI:1.07~1.41,P=0.003),fasting plasma glucose(OR=1.67,95%CI:1.10~2.54,P=0.016)and CTO of right coronary artery(OR=0.70,95%CI:0.51~0.96,P=0.027)were independent factors affecting CCV.The results of ROC analysis showed that the best cut-off point of level of HCgp-39 was 110.4 ng/ml in prediction of poor CCV,and its sensitivity was 73%and specificity was 80%.Conclusion The level of serum HCgp-39 is closely correlated to angiogenesis of CCV,and HCgp-39 is an independent factor affecting angiogenesis of CCV in CTO patients.