冠心病患者冠状动脉CT 特征与血清脂蛋白(a)、脂联素、PTX3的相关性研究

Study on the correlation between CT features of coronary artery and serum lipoproteins(a),adiponectin,PTX3 in patients with coronary heart disease

目的探讨冠心病(CHD)患者冠状动脉CT特征与血清脂蛋白(a)[LP(a)]、脂联素(ADP)、五聚素3(PTX3)的相关性。方法选取本院2018年6月至2019年10月102例CHD患者作为观察组,均采用128层螺旋CT行冠状动脉CT血管成像(CTA),并选取同期健康体检者104例作为正常对照组,检测对比两组血清LP(a)、ADP、PTX3水平。比较CT特征中不同冠状动脉狭窄程度、斑块性质(CT值)患者血清LP(a)、ADP、PTX3水平,分析血清LP(a)、ADP、PTX3与冠状动脉狭窄程度、斑块性质的相关性。结果102例CHD患者的CT特征:轻度狭窄34例,中度狭窄42例,重度狭窄21例,闭塞5例;软斑块40例,钙化斑块34例,混合斑块28例。观察组血清LP(a)、PTX3水平高于正常对照组,ADP水平低于正常对照组(P<0.05);观察组血清LP(a)、PTX3水平随冠状动脉狭窄程度增加呈升高趋势,ADP水平呈降低趋势(P<0.05);血清LP(a)(r=0.681)、PTX3(r=0.730)与冠状动脉狭窄程度呈正相关,ADP(r=-0.646)与冠状动脉狭窄程度呈负相关(P<0.05);混合斑块患者血清LP(a)、PTX3水平高于钙化斑块、软斑块患者,ADP水平低于钙化斑块、软斑块患者(P<0.05);血清LP(a)(r=0.790)、PTX3(r=0.844)与斑块性质呈正相关,ADP(r=-0.566)与斑块性质呈负相关(P<0.05)。结论血清LP(a)、ADP、PTX3与CHD患者CT特征密切相关,可作为评估冠状动脉狭窄程度、斑块性质的重要生理病理改变因子,为临床诊治提供可靠参考依据。

Objective To investigate the correlation between CT features of coronary artery and serum lipoproteins(a)[LP(a)],adiponectin(ADP),pentalin 3(PTX3)in patients with coronary heart dis⁃ease(CHD).Methods A total of 102 patients with CHD in our hospital from June 2018 to October 2019 were selected as the observation group,coronary CT angiography(CTA)was performed with 128⁃slice spiral CT,a total of 104 healthy subjects were selected as the normal control group,and serum LP(a),ADP,and PTX3 levels were detected and compared between the two groups.Compare serum LP(a),ADP,PTX3 levels in patients with different coronary stenosis and plaque properties(CT value)in CT features,correlation between serum LP(a),ADP,PTX3 and the degree of coronary artery stenosis and plaque properties was ana⁃lyzed.Results The CT characteristics of 102 patients with CHD were:mild stenosis in thirty⁃four cases,moderate stenosis in forty⁃two cases,severe stenosis in twenty one cases,and occlusion in five cases;There were forty soft plaques,thirty⁃four calcified plaques,and twenty⁃eight mixed plaques.The levels of serum LP(a)and PTX3 in the observation group were higher than those in the normal control group,and the levels of ADP were lower than those in the normal control group(P<0.05);The levels of serum LP(a)and PTX3 in the observation group increased with the increase of the degree of coronary stenosis,and the ADP level decreased(P<0.05);Serum LP(a)(r=0.681)and PTX3(r=0.730)were positively correlated with the degree of coro⁃nary stenosis,and ADP(r=-0.646)was negatively correlated with the degree of coronary stenosis(P<0.05);Patients with mixed plaque had higher serum LP(a)and PTX3 levels than those with calcified plaque and soft plaque,and ADP levels were lower than those with calcified plaque and soft plaque(P<0.05);Serum LP(a)(r=0.790)and PTX3(r=0.844)had a positive correlation with plaque properties,and ADP(r=-0.566)had a negative correlation with plaque properties(P<0.05).Conclusion Serum LP(a),ADP,and PTX3 are closely related to CT characteristics of patients with CHD and can be used as important physiological and patho⁃logical factors to evaluate the degree of coronary artery stenosis and plaque properties,and provide a reliable reference for clinical diagnosis and treatment.