老年冠心病患者血清亲环素A、视黄醇结合蛋白4、胰岛素样生长因子-1水平与冠状动脉病变相关性

Changes of serum cyclophilin A,insulin-like growth factor-1,retinol binding protein 4 levels and degree of lesion in elderly patients with coronary heart disease

目的探讨老年冠心病患者血清亲环素A(CyPA)、胰岛素样生长因子-1(IGF-1)、视黄醇结合蛋白4(RBP4)水平,分析其与冠状动脉病变的相关性。方法选取自2016年12月至2018年12月收治的226例老年冠心病患者为冠心病组,另选80例老年无冠心病者为非冠心病组。冠心病组患者根据冠状动脉病变支数分为单支组(n=96)、双支组(n=71)、三支组(n=59)。比较各组血清CyPA、IGF-1、RBP4水平,并分析CyPA、IGF-1、RBP4与冠心病病变支数的相关性。采用多因素Logistic回归分析对冠状动脉病变的危险因素进行分析。结果冠心病组吸烟、糖尿病、高血压病的患者比例均高于非冠心病组,差异有统计学意义(P<0.05)。冠心病组血清CyPA、IGF-1、RBP4水平均高于非冠心病组,差异有统计学意义(P<0.05)。三支组、双支组患者血清CyPA、IGF-1、RBP4水平高于单支组,且三支组患者血清CyPA、IGF-1、RBP4水平高于双支组,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,患者血清CyPA、RBP4、IGF-1水平变化与冠状动脉病变支数呈正相关(r=0.645,r=0.418,r=0.536,P<0.05)。患者吸烟史、高血压、糖尿病及血清CyPA、IGF-1、RBP4升高是冠状动脉病变的独立危险因素(P<0.05)。血清CyPA预测冠状动脉病变的灵敏度、特异度为0.812、0.800;血清IGF-1预测冠状动脉病变的灵敏度、特异度为0.749、0.750;血清RBP4预测冠状动脉病变的灵敏度、特异度为0.742、0.700。血清CyPA、IGF-1、RBP4预测冠状动脉病变程度的临界值分别为34.22 ng/ml、645.81μg/L、35.49 ng/ml。结论血清CyPA、IGF-1、RBP4水平与冠心病病变程度呈正相关,是冠状动脉病变发生的独立危险因素,对冠状动脉病变有一定临床诊断价值。

Objective To investigate the relationship between the changes of serum CyPA,IGF-1 and RBP4 levels and the severity of coronary heart disease in elderly patients.Methods A total of 226 elderly patients with coronary heart disease were selected.According to the range of coronary artery disease,there were 96 cases in single group,71 cases in double group,59 cases in three groups,and 80 cases in healthy group.The differences of serum CyPA,IGF-1 and RBP4 were compared.The correlations between CyPA,IGF-1 and RBP4 and the severity of coronary heart disease were analyzed.Multifactor logistic regression analysis was used to analyze the risk factors of coronary artery disease.Results The levels of serum CyPA,IGF-1 and RBP4 in the coronary heart disease group were higher than those in the control group(P<0.05);The levels of serum CyPA,IGF-1 and RBP4 in the three groups were higher than those in the double and single groups(P<0.05).Conclusion Serum CyPA,IGF-1,and RBP4 levels are positively correlated with the severity of coronary heart disease.They are independent risk factors for coronary artery disease and can be used as biological indicators for the diagnosis of coronary heart disease in the elderly.