老年冠状动脉疾病患者血清Wnt-1水平对冠状动脉病变性质的预测价值

Predictive value of serum Wnt-1 level in elderly patients with coronary artery disease on the nature of coronary artery disease

目的检测老年冠状动脉疾病(CAD)患者血清Wnt(wingless type protein)-1水平,探讨Wnt-1与炫速双源CT造影冠状动脉病变严重程度和形态的相关性。方法选取2016年10月至2018年5月就诊于郑州大学第一附属医院心血管内科且年龄大于60岁的疑似冠心病患者371例,行炫速双源CT冠状动脉造影术,按管腔狭窄程度分组,≤50%为非严重冠状动脉病变,>50%为严重狭窄病变,根据冠状动脉斑块钙化情况分为非钙化斑块,钙化斑块和混合斑块。采用酶联免疫吸附试验(ELISA)法测定血清Wnt-1水平。结果严重冠状动脉病变组血清Wnt-1水平明显高于非严重冠状动脉病变组(132.52±40.48)vs.(98.39±28.23)ng/ml,P<0.001)。logistic回归分析发现血清Wnt-1水平是预测严重冠状动脉病变的独立预测因子(OR=1.56,95%CI:1.24~2.03,P=0.003)。并且冠状动脉钙化组血清Wnt-1水平(135.56±38.82)ng/ml显著高于非冠状动脉钙化组(96.75±29.13)ng/ml和混合斑块组(102.62±34.64)ng/ml(P<0.001)。logistic回归分析显示血清Wnt-1水平是预测冠状动脉钙化的独立预测因子(OR=2.07,95%CI:1.53~2.85,P<0.001)。结论血清Wnt-1水平显著与冠状动脉CT造影老年血管斑块严重程度和钙化密切相关。Wnt在老年冠状动脉疾病中的病理生理机制需要进一步的前瞻性临床研究。

Objective To detect serum Wnt(wingless type protein)-1 levels in elderly patients with coronary artery disease(CAD),and to explore the correlation between Wnt-1 and the severity and morphology of coronary arterial lesions in dual-source CT angiography.Methods A total of 371 patients with suspected coronary heart disease who were seen in the Department of Cardiovascular Diseases of the First Affiliated Hospital of Zhengzhou University from October 2016 to May 2018 and were older than 60 years were selected for dual-source CT coronary angiography.In groups,≤50%are non-severe coronary lesions,and>50%are severe stenosis lesions.According to coronary plaque calcification,it is divided into non-calcified plaques,calcified plaques and mixed plaques.Enzyme-linked immunosorbent assay(ELISA)was used to determine serum Wnt-1 levels.Results The level of serum Wnt-1 in severe coronary artery disease group was significantly higher than that in non-severe coronary artery disease group(132.52±40.48)vs.(98.39±28.23)ng/ml,P<0.001).Logistic regression analysis found that serum Wnt-1 level was an independent predictor of severe coronary artery disease(OR=1.56,95%CI:1.24~2.03,P=0.003).And the serum Wnt-1 level(135.56±38.82)ng/ml in coronary calcification group was significantly higher than that in non-coronary calcification group(96.75±29.13)ng/ml and mixed plaque group(102.62±34.64)ng/ml(P<0.001).Logistic regression analysis showed that serum Wnt-1 level was an independent predictor of coronary calcification(OR=2.07,95%CI:1.53~2.85,P<0.001).Conclusions Serum Wnt-1 level is significantly related to the severity of vascular plaque and calcification in elderly patients with coronary CT angiography.The pathophysiology of Wnt in elderly coronary artery disease requires further prospective clinical research.