白介素-18及中性粒细胞明胶酶相关脂质运载蛋白与不稳定型心绞痛合并原发性高血压的相关性研究

Correlation between interleukin-18 and neutrophil gelatinase-associated lipocalin and unstable angina pectoris complicated with hypertension

目的:探讨白介素-18(IL-18)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在不稳定型心绞痛(UA)合并原发性高血压(EH)患者的相关性。方法:收集2017年4月至2019年4月,于承德医学院附属医院心脏内科以UA收入院并行冠状动脉造影患者238例,根据是否合并EH分为UA+EH组(n=95),UA组(n=53),EH组(n=46)、对照组(n=44)。比较各组患者基础资料、血生化指标、IL-18及NGAL差异,进行偏相关分析,采用析因设计方差分析比较UA和EH交互作用对血清IL-18、NGAL水平的影响,用ROC曲线分析IL-18、NGAL对UA+EH的预测价值。结果:与对照组相比,UA+EH组血清IL-18、NGAL水平高于其他三组(P<0.05);相关性分析显示,血清IL-18、NGAL水平与UA+EH患者冠状动脉Gensini评分呈明显正相关(P<0.05);析因设计方差分析显示,UA和EH在IL-18、NGAL水平升高方面存在交互作用(P<0.05),简单效应分析表明UA患者IL-18、NGAL水平明显升高,且对合并EH患者IL-18、NGAL水平显著高于单纯UA患者(P<0.05);ROC曲线显示:IL-18、NGAL在预测UA曲线下面积分别为:0.795(95%CI:0.709~0.881)、0.773(95%CI:0.677~0.870),而IL-18、NGAL在预测UA+EH其特异度、敏感度均高于单纯UA患者且二者联合检测UA+EH预测价值高于单一指标,差异均有统计学意义(P<0.05)。结论:UA和EH的交互作用共同促进IL-18、NGAL水平的升高,IL-18、NGAL联合检测可提高UA+EH预测的准确性。

Objective:To investigate the levels and significance of interleukin-18(IL-18)and neutrophil gelatinase-associated lipocalin(NGAL)in patients with unstable angina pectoris(UA)and essential hypertension(EH).Methods:From April 2017 to April 2019,238 patients undergoing coronary angiography in the Department of Cardiology of the Affiliated Hospital of Chengde Medical College were included in the UA.The patients were divided into UA+EH group(n=95),and UA group(n=53),EH group(n=46),and control group(n=44).Compare the basic data,blood biochemical indicators,IL-18 and NGAL differences of patients in each group,and conduct partial correlation analysis.Use factorial design analysis of variance to compare the effect of UA and EH interaction on serum IL-18 and NGAL levels,and use ROC curve analysis.The predictive value of IL-18 and NGAL on UA+EH.Results:Compared with the control group,the levels of serum IL-18 and NGAL in the UA+EH group were higher than those in the other three groups(P<0.05).Correlation analysis showed that serum IL-18,NGAL and coronary genusini scores were significantly positive in patients with UA+EH Correlation(P<0.05);factorial design analysis of variance showed that UA and EH interacted with elevated levels of serum IL-18 and NGAL,and simple effects analysis showed that IL-18 levels were higher in UA+EH patients than in EH patients 32.732 g/L 119.927 g/L higher than IL-18 level in UA patients;NGAL level in UA+EH patients was 10.403 g/l higher than EH patients,and 26.305 g/l higher than NGAL levels in UA patients,(P<0.05);ROC analysis suggested that the combined detection of IL-18 and NGAL had a higher predictive value for UA+EH(P<0.05).Conclusions:There is an interaction between UA and EH in the elevated levels of IL-18 and NGAL.The combined detection of UA+EH with multiple indicators has higher clinical value.