液相串联三重四级杆质谱测定冠心病患者尿液儿茶酚胺及其代谢产物的临床分析

Determination of urine catecholamines and their metabolites in coronary heart disease patients by liquid chromatography-triple quadrupole mass spectrometry

目的:不良的心理行为因素能导致机体儿茶酚胺水平升高,可能与冠心病的发生和预后相关.通过测定冠心病患者尿液中儿茶酚胺的含量,可以初步探讨儿茶酚胺浓度水平与冠心病发生之间的关系.方法:筛选26例冠心病及28例对照组患者,用液相串联三重四级杆质谱技术对患者进行24小时尿儿茶酚胺及其代谢产物进行浓度测定.采用c^(2)检验分析比较实验组和对照组的儿茶酚胺及其代谢产物、空腹血糖、总胆固醇、低密度脂蛋白、高密度脂蛋白和甘油三酯水平,采用Logistic回归、受试者工作特征曲线(ROC)研究儿茶酚胺及其代谢产物和其他因素对冠心病的预测价值.结果:冠心病组与对照组间比较,冠心病组血清低密度脂蛋白水平均较高,差异有统计学意义.二元单因素及多因素Logistic回归分析显示,游离多巴胺浓度水平有明显差异(t/c^(2)=4.68,P<0.05),是冠心病的独立预测因子.ROC曲线显示游离多巴胺对冠心病预测更有意义(P<0.05).结论:游离多巴胺与冠心病的发生密切相关,对冠心病有很好的预测价值.

Objective Adverse psychological behavior factors can lead to the increase of catecholamine levels,which may be related to the occurrence and prognosis of coronary heart disease.By measuring the content of catecholamine in urine of patients with coronary heart disease,the relationship between the concentration of catecholamine and the occurrence of coronary heart disease can be preliminarily discussed.Methods Twenty-six patients with coronary heart disease(CHD)and 28 patients with the control group were screened.The concentrations of catecholamines and their metabolites in urine for 24 hours were determined by liquid phase tandem triple quadruple rod mass spectrometry.The levels of catecholamines and their metabolites,total cholesterol,low density lipoprotein,high density lipoproteinand triglyceride,and fasting blood glucose were analyzed and compared between the experimental group and the control group using the c^(2) test.Logistic regression,receiver operating characteristic(ROC)curve were used to analyse the predictive value of catecholamines,their metabolites and other biochemical indicators for coronary heart disease.Results The serum LDL level of the experimental group was higher than that of the control group,and the difference was statistically significant.Binary univariate and multivariate Logistic regression analysis showed significant difference in free dopamine concentration(t/c^(2)=4.68,P<0.05)between two groups,and free dopamine concentration was an independent predictor of CHD.Receiver operating characteristic(ROC)curve showed that free dopamine was more significant in predicting coronary heart disease(P<0.05)between the CHD group and the group without CHD.Conclusion Free dopamine is closely related to the occurrence of coronary heart disease and has a good predictive value for coronary heart disease.