血清半乳糖凝集素-9、碱性磷酸酶、基质金属蛋白酶-9水平对冠状动脉性心脏病患者冠脉易损斑块的诊断价值

Diagnostic Value of Serum Galectin-9, Alkaline Phosphatase and Matrix Metalloproteinase-9 Levels for Vulnerable Coronary Plaques in Patients with Coronary Artery Heart Disease

目的评价血清半乳糖凝集素-9(galectin-9)、碱性磷酸酶(ALP)、基质金属蛋白酶-9(MMP-9)水平对冠状动脉性心脏病(CHD)患者冠状动脉易损斑块的诊断价值。方法回顾性分析2018年10月至2020年10月收治的128例CHD患者。根据CT冠脉造影分为稳定型心绞痛组(SAP组)60例和急性冠脉综合征组(ACS组)68例。根据斑块性质分为稳定斑块组60例、易损斑块组38例和混合斑块组30例,同时选取于同期进行体检的50名健康志愿者作为健康对照组。检测血清galectin-9、ALP、MMP-9水平。绘制CHD患者血清galectin-9、ALP、MMP-9水平预测冠状动脉易损斑块的受试者操作特征曲线(ROC)曲线。分析CHD患者血清galectin-9水平与ALP、MMP-9水平的相关性。结果ACS组患者易损斑块比例高于SAP组患者,而稳定斑块比例低于SAP组患者,且差异均有统计学意义(P均<0.05)。ACS组、SAP组患者血清galectin-9、ALP、MMP-9水平均高于健康对照组,ACS组患者血清galectin-9、ALP、MMP-9水平均高于SAP组患者,且差异均有统计学意义(P均<0.05)。易损斑块组、混合斑块组及稳定斑块组患者血清galectin-9、ALP、MMP-9水平均高于健康对照组,易损斑块组患者血清galectin-9、ALP、MMP-9水平均高于混合斑块组及稳定斑块组患者,混合斑块组患者血清galectin-9、ALP、MMP-9水平均高于稳定斑块组患者,且差异均有统计学意义(P均<0.05)。ROC曲线显示,CHD患者血清galectin-9、ALP、MMP-9水平联合预测冠状动脉易损斑块的敏感度、特异度及曲线下面积(AUC)均高于单独检测(P均<0.05);Spearman相关分析显示,CHD患者血清galectin-9水平与ALP、MMP-9水平呈正相关(r=0.381、0.377,P<0.001)。结论血清galectin-9、ALP、MMP-9水平对CHD患者冠状动脉易损斑块预测价值较高,有助于临床制定针对性治疗方案。

Objective To observe the diagnostic value of serum galectin-9,alkaline phosphatase(ALP)and matrix metalloproteinase-9(MMP-9)for vulnerable coronary plaques in patients with coronary artery heart disease(CHD).Methods A total of 128 CHD patients admitted to the hospital from October 2018 to October 2020 were enrolled as observation group.According to coronary angiography,they were divided into stable angina pectoris(SAP)group(n=60)and acute coronary syndrome(ACS)group(n=68).According to properties of plaques after CT coronary angiography examination,they were divided into stable plaque group(n=60),vulnerable plaque group(n=38)and mixed plaque group(n=30).A total of 50 healthy controls who underwent physical examination in the hospital were enrolled as control group.The levels of serum galectin-9,ALP and MMP-9 were detected.The predictive value of galectin-9,ALP and MMP-9 for vulnerable coronary plaques was analyzed by receiver operator characteristic(ROC)curves.And the correlation among serum galectin-9,ALP and MMP-9 was analyzed.Results The distribution of vulnerable plaques in ACS group was higher than that in SAP group,while distribution of stable plaques was lower than that in SAP group(P<0.05).The levels of serum galectin-9,ALP and MMP-9 in ACS group and SAP group were higher than those in control group(P<0.05),which were higher in ACS group than SAP group(P<0.05).The levels of serum galectin-9,ALP and MMP-9 in vulnerable plaque group,mixed plaque group and stable plaque group were higher than those in control group(P<0.05).The levels of serum galectin-9,ALP and MMP-9 were the highest in vulnerable plaque group,followed by mixed plaque group and stable plaque group(P<0.05).ROC curve analysis showed that sensitivity,specificity and area under curve(AUC)of serum galectin-9 combined with ALP and MMP-9 for predicting vulnerable coronary plaques were higher than those of single index(P<0.05).Spearman correlation analysis showed that serum galectin-9 level was positively correlated with ALP and MMP-9 levels(r=0.381,0.377,P<0.05).Conclusion The levels of serum galectin-9,ALP and MMP-9 are of high predictive value for vulnerable coronary plaques in CHD patients,which is conductive to the formulation of clinical treatment plans.