mtDNA含量和AIP与急性冠脉综合征的关系

Relationship between mtDNA content and AIP and acute coronary syndrome

目的探讨患者外周血线粒体DNA(mtDNA)含量和血浆致动脉硬化指数(AIP)与急性冠脉综合征(ACS)的关系。方法连续纳入2016年9月至2017年4月于承德医学院附属医院心血管内科行冠状动脉造影术的244例患者,根据造影结果将其分为冠心病组(183例)和非冠心病组(61例)。根据Gensini评分三分位数,将所有入选者分为低、中、高3组。采用实时荧光定量PCR的方法检测患者的外周血mtDNA含量,日立全自动7600生化分析仪测定生化指标。根据冠脉血管狭窄程度,分析mtDNA含量、AIP与急性冠脉综合征的关系。结果冠心病组比非冠心病组mtDNA含量低、AIP高,差异有统计学意义(P<0.05)。随Gensini评分三分位数的增加,mtDNA含量下降、AIP增加,差异有统计学意义(P<0.05)。ROC曲线分析显示,mtDNA含量用于诊断ACS的曲线下面积为0.858,敏感度及特异度分别为0.760和0.836,约登指数为0.596。AIP用于诊断ACS的曲线下面积为0.644,敏感度及特异度分别为0.776和0.508,约登指数为0.284;mtDNA含量和AIP联合诊断ACS的曲线下面积为0.865,敏感度及特异度分别为0.765和0.820,约登指数为0.585。mtDNA含量与Gensini评分呈负相关(rs=-0.585),AIP与Gensini评分呈正相关(rs=0.145)。结论mtDNA含量和AIP与急性冠脉综合征密切相关,mtDNA含量以及AIP在急性冠脉综合征诊断中有临床应用价值。

Objective To investigate the relationship between mitochondrial DNA(mtDNA)content in peripheral blood and atherogenic index of plasma(AIP)and acute coronary syndrome(ACS)in patients with ACS.Methods A total of 244 patients who underwent coronary angiography in the Department of Cardiovascular Medicine of Affiliated Hospital of Chengde Medical University from September 2016 to April 2017 were continuously included in the study.According to the results of angiography,the selected patients were divided into the coronary heart disease(CHD)group(183 cases)and the non-coronary heart disease(non-CHD)group(61 cases).All the selected people were divided into three groups-the low,medium and high group by tertiles of Gensini score.Real-time fluorescence quantitative PCR was used to detect mtDNA content in peripheral blood of patients,and Hitachi automatic 7600 biochemical analyzer was used to determine biochemical indexes.According to the degree of coronary stenosis,the relationship between mtDNA content,AIP and ACS was analyzed.Results The mtDNA content was significantly lower and AIP was higher in CHD group than that in non-CHD group,with statistically significant differences(P<0.05).With the increase of tertiles of Gensini score,mtDNA content decreased and AIP increased,with statistically significant difference(P<0.05).ROC analyses showed that the area under the curve(AUC)of mtDNA content in diagnosing ACS was 0.858,the sensitivity and specificity were 0.760 and 0.836,respectively,and the Yorden index was 0.596.The AUC of AIP in the diagnosis of ACS was 0.644,the sensitivity and specificity were 0.776 and 0.508,respectively,and the Yorden index was 0.284.The AUC of the combined diagnosis of mtDNA content and AIP was 0.865,the sensitivity and specificity were 0.765 and 0.820,respectively,and the Yorden index was 0.585.There was a negative correlation between mtDNA content and Gensini score(rs=-0.585),and a positive correlation between AIP and Gensini score(rs=0.145).Conclusion MtDNA content and AIP are closely related to ACS.MtDNA content and AIP show a clinical application value in the diagnosis of ACS.