血清胆红素、NO、ET-1、VEGF水平联合检测对冠心病诊断价值

Diagnostic Value of Combined Detection of Serum Bilirubin,No,ET-1 and VEGF Levels in Coronary Heart Disease

目的:探讨血清胆红素、一氧化氮(NO)、内皮素-1(ET-1)、血管内皮生长因子(VEGF)水平联合检测对冠心病(CHD)的诊断价值。方法:选取2019年12月至2020年12月在我院治疗的冠心病患者65例作为观察组;另选取同期参与健康体检的60例健康人群作为对照组。对所有患者总胆红素水平(TBIL)、直接胆红素水平(DBIL)、NO、ET-1、VEGF表达水平进行检测,计算间接胆红素水平(IBIL),采用受试者工作特征曲线(ROC)下面积(AUC)比较血清胆红素、VEGF、ET-1和NO单独和联合检测对冠心病的诊断价值,采用单因素和多因素logistic回归分析法分析冠心病的影响因素。结果:与对照组相比,观察组患者血清IBIL、DBIL、TBIL、VEGF和NO检测结果均显著降低,ET-1检测结果显著升高(P<0.05)。血清胆红素、VEGF、ET-1和NO对冠心病联合检测的AUC值显著高于单独检测值(P<0.05)。观察组患者高血压、糖尿病、血脂异常、吸烟、肥胖的发生率明显高于对照组(P<0.05)。多因素非条件logistic回归分析结果显示,高血压、糖尿病、血脂异常、吸烟、肥胖、血清胆红素、VEGF、ET-1和NO均可作为评估冠心病的危险因素,其中血清检测指标的关联强度依次为ET-1、VEGF、NO、胆红素(P<0.05)。结论:冠心病患者血清胆红素代谢异常,血管内皮功能指标紊乱,是导致患者动脉粥样硬化的重要原因。血清胆红素、NO、ET-1、VEGF水平联合检测对冠心病诊断效能明显优于单个指标,且可作为冠心病发病风险的有效指标。

Objective:To investigate the diagnostic value of combined detection of serum bilirubin,no,ET-1 and VEGF levels in coronary heart disease.Methods:65 patients with coronary heart disease treated in our hospital from December 2019 to December 2020 were selected as the observation group,and 60 healthy people who participated in the physical examination at the same period were selected as the control group.Total bilirubin levels(TBIL),direct bilirubin levels(DBIL),NO,ET-1 and VEGF expression levels were detected in all patients,and indirect bilirubin levels(IBIL)were calculated,and the correlation between each index was analyzed.The area under receiver operating characteristic curve(ROC)(AUC)was used to compare the diagnostic value of serum bilirubin,VEGF,ET-1 and NO alone and in combination in the diagnosis of coronary heart disease,and single factor and multivariate logistic regression analysis were used.Influencing factors of coronary heart disease.Results:Compared with the control group,the results of serum IBIL,DBIL,TBIL,VEGF and NO in the observation group were lower,the results of ET-1 increased(P<0.05).The AUC value of the combined detection of serum bilirubin,VEGF,ET-1 and NO for coronary heart disease was higher than the single detection value(P<0.05);the incidence of hypertension,diabetes,dyslipidemia,smoking,and obesity in the observation group higher than control group(P<0.05).The results of multivariate unconditional logistic regression analysis showed that hypertension,diabetes,dyslipidemia,smoking,obesity,serum bilirubin,VEGF,ET-1 and NO were all risk factors for coronary heart disease,and the correlation strength of serum detection indexes was ET-1,VEGF,NO and bilirubin(P<0.05).Conclusion:Abnormal metabolism of serum bilirubin and dysfunction of vascular endothelial function are important causes of atherosclerosis in patients with coronary heart disease.Combined detection of serum bilirubin,NO,ET-1 and VEGF levels is significantly better than single index in the diagnosis of CORONARY heart disease,and can be used as an effective indicator of the risk of coronary heart disease.