动脉僵硬度和骨保护素对稳定型冠状动脉疾病患者的预后评估

Prognostic Value of Arterial Stiffness and Osteoprotegerin in Patients with Stable Coronary Artery Disease

目的探讨动脉僵硬度和骨保护素对稳定型冠状动脉疾病(stable coronary artery disease,SCAD)患者预后的预测价值。方法回顾性选择在我院接受冠状动脉介入治疗的SCAD患者160例作为研究对象。根据随访期间有无主要不良心血管事件(major adverse cardiovascular events,MACE)发生分为MACE发生组(n=70)和MACE未发生组(n=90)。比较两组患者在临床特征方面的差异。通过绘制受试者工作特征曲线(receiver operating characteristic curve,ROC),筛选切点,计算曲线下面积评估不同参数预测SCAD患者MACE发生效力。应用多因素非条件Logistic回归分析影响SCAD患者MACE发生的危险性因素。结果MACE未发生组左心室射血分数高于MACE发生组,Gensini评分、脉搏波速度(pulse wave velocity,PWV)、骨保护素水平低于MACE发生组,差异有统计学意义(均P<0.05)。左心室射血分数、Gensini评分、PWV、骨保护素预测SCAD患者MACE发生的诊断界值分别为50.00%、32.35分、8.85m/s、3.78pmol/L(均P<0.05)。多因素Logistic回归分析结果显示,Gensini评分≥32.35分、PWV≥8.85m/s、骨保护素≥3.78pmol/L增加SCAD患者MACE发生风险(OR=3.72~3.85,均P<0.05)。结论Gensini评分、PWV、骨保护素水平与SCAD患者MACE发生密切相关。PWV和骨保护素水平偏高不利于SCAD患者预后。

Objective To investigate the prognostic role of arterial stiffness and osteoprotegerin in patients with stable coronary artery disease(SCAD).Methods 160 patients with SCAD received coronary intervention therapy in our hospital were selected.The patients were divided into MACE group(n=70)and non-MACE group(n=90)according to whether MACE happened or not during the follow-up period.The differences in clinical characteristics between the two groups were compared.The ROC curve was drawn,the cut points were selected,the area under the curve was calculated,and the different parameters were used to predict the effectiveness of MACE in SCAD patients.Multivariate logistic regression analysis was used to analyze the risk factors of MACE in SCAD patients.Results The left ventricular ejection fraction in non-MACE group was higher than that in MACE group,while Gensini score,PWV,and osteoprotegerin were lower than those in MACE group,the difference were statistically significant(P<0.05).The diagnostic values of left ventricular ejection fraction,Gensini score,PWV and osteoprotegerin in predicting the occurrence of MACE in SCAD patients were 50.00%,32.35 points,8.85 m/s and 3.78 pmol/L,respectively(P<0.05).The results of multiple factor logistic regression analysis showed that the Gensini score≥32.35 points,PWV≥8.85 m/s,and osteoprotegerin≥3.78 pmol/L increased the risk of MACE occur in SCAD patients(OR=3.72~3.85,P<0.05).Conclusions Gensini score,PWV and osteoprotegerin are closely related to MACE in SCAD patients.The high level of PWV and osteoprotegerin is bad for the prognosis of SCAD patients.