冠心病患者血清成纤维细胞生长因子23、碱性磷酸酶及胎球蛋白A水平与冠状动脉钙化的关系及其预测价值分析

Relationship between Serum Fibroblast Growth Factor 23,Alkaline Phosphatase and Fetuin-A Levels and Coronary Artery Calcification in Patients with Coronary Artery Disease and Their Predictive Value Analysis

目的:分析冠心病(CHD)患者血清成纤维细胞生长因子23(FGF23)、碱性磷酸酶(ALP)、胎球蛋白A(FA)水平与冠状动脉钙化(CAC)的关系并探讨其对CAC的预测价值。方法:选取2021年2月~2022年2月本院收治的165例CHD患者,根据是否伴有CAC分为CAC组(n=73)和非CAC组(n=92)。收集患者临床资料,采用酶联免疫吸附法(ELISA)检测血清FGF23、ALP、FA水平。通过多因素Logistic回归分析CHD患者CAC的影响因素,绘制受试者工作特征(ROC)曲线分析血清FGF23、ALP、FA水平对CHD患者CAC的预测价值。结果:CAC组血清FGF23、ALP水平高于非CAC组,血清FA水平低于非CAC组(均P<0.01)。多因素Logistic回归分析显示,年龄(较大)(OR=1.220,95%CI:1.087~1.369)、高血压病(OR=1.461,95%CI:1.062~2.010)、血钙(较高)(OR=1.532,95%CI:1.042~2.251)、血磷(较高)(OR=1.209,95%CI:1.097~1.333)、FGF23(较高)(OR=1.012,95%CI:1.007~1.018)、ALP(较高)(OR=1.046,95%CI:1.023~1.070)为CHD患者CAC的独立危险因素,FA(较高)(OR=0.827,95%CI:0.750~0.912)为独立保护因素(均P<0.05)。ROC曲线分析显示,血清FGF23、ALP、FA单独与联合预测CHD患者CAC的曲线下面积(AUC)分别为0.790、0.773、0.786、0.915,联合预测CHD患者CAC的AUC大于各指标单独预测。结论:血清FGF23、ALP水平升高和FA水平降低与CHD患者发生CAC密切相关,可作为CHD患者发生CAC的辅助预测指标,且三个指标联合预测CHD患者CAC发生风险的价值较高。

Objective:To analyze the relationship between serum fibroblast growth factor 23(FGF23),alkaline phosphatase(ALP)and fetuin-A(FA) levels and coronary artery calcification(CAC) in patients with coronary heart disease(CHD) and to explore their predictive value for CAC.Methods:165 patients with CHD who were admitted to our hospital from February 2021 to February 2022 were selected,and they were divided into CAC group(n=73) and no-CAC group(n=92) according to whether they were accompanied by CAC or not.Clinical data of the patients were collected,and serum FGF23,ALP and FA levels were measured by enzyme-linked immunosorbent assay(ELISA).The influencing factors of CAC in patients with CHD were analyzed by multivariate Logistic regression,and the predictive value of serum FGF23,ALP and FA levels on CAC in patients with CHD was drawed by receiver operating characteristic(ROC)curves.Results:Serum FGF23 and ALP levels in the CAC group were higher than in the no-CAC group,and FA level was lower than thae in the no-CAC group(all P<0.01).Multivariate Logistic regression analysis showed that that age(older)(OR=1.220,95% CI:1.087~1.369),hypertension(OR=1.461,95%CI:1.062~2.010),blood calcium(higher)(OR=1.532,95%CI:1.042~2.251),blood phosphorus(higher)(OR=1.209,95%CI:1.097~1.333),FGF23(higher)(OR=1.012,95%CI:1.007~1.018),ALP(higher)(OR=1.046,95%CI:1.023~1.070) were independent risk factors for CAC in patients with CHD,FA(higher)(OR=0.827,95%CI:0.750~0.912) was independent protective factor(all P<0.05).ROC curve analysis showed that the area under the curve(AUC) of serum FGF23,ALP and FA were 0.790,0.773,0.786 and 0.915,respectively,and the AUC of serum FGF23,ALP and FA in combination with CHD was greater than that of each indicator alone.Conclusion:The serum FGF23 and ALP levels increased and serum FA level decreased are closely related to the occurrence of CAC in patients with CHD,which can be used as auxiliary predictors of THE occurrence of CAC in patients with CHD,and the combined prediction value of the three indicators is high in the risk of CAC in patients with CHD.