不稳定型心绞痛合并2型糖尿病患者血清松弛素2和钙调理蛋白1的表达及临床意义

Expression and clinical significance of serum relaxin 2 and calponin 1 in patients with unstable angina pectoris complicated with type 2 diabetes mellitus

目的探讨不稳定型心绞痛(UAP)合并2型糖尿病(T2DM)患者血清松弛素2及钙调理蛋白1(CNN1)的表达及临床意义。方法选取2018年2月至2020年2月在湖北省武汉市红十字会医院诊治的120例UAP患者为研究对象,根据是否有T2DM分为UAP组(62例)和UAP合并T2DM组(58例)。采用酶联免疫吸附试验法检测2组患者血清松弛素2、CNN1水平。比较2组一般临床资料及血清松弛素2、CNN1水平。分析UAP合并T2DM患者血清松弛素2、CNN1与临床指标的相关性。采用多因素Logistic回归分析影响UAP合并T2DM发生的因素。采用受试者工作特征曲线分析血清松弛素2、CNN1单独及联合检测对UAP合并T2DM的预测价值。结果UAP合并T2DM组三酰甘油、空腹血糖、高敏C反应蛋白(hs-CRP)、Gensini评分、松弛素2及CNN1水平均明显高于UAP组(均P<0.05)。UAP合并T2DM患者血清松弛素2与空腹血糖、hs-CRP呈显著正相关,CNN1与空腹血糖、hs-CRP和Gensini评分呈显著正相关(均P<0.05)。松弛素2(比值比=1.347,95%置信区间:1.085~1.674,P=0.008)、CNN1(比值比=2.172,95%置信区间:1.098~4.296,P=0.007)是影响UAP合并T2DM发生的独立因素。血清松弛素2、CNN1单独及联合检测对UAP合并T2DM预测的曲线下面积为0.769、0.786、0.875,血清松弛素2、CNN1联合检测预测的曲线下面积显著高于血清松弛素2、CNN1单独检测(Z=3.810、3.509,均P<0.001)。结论UAP合并T2DM患者血清松弛素2、CNN1表达升高,松弛素2、CNN1是影响UAP合并T2DM发生的相关因素,血清松弛素2、CNN1联合检测对UAP合并T2DM具有较高的预测价值。

Objective To investigate the expression and clinical significance of serum relaxin 2(RLX2)and calponin 1(CNN1)in patients with unstable angina pectoris(UAP)complicated with type 2 diabetes mellitus(T2DM).Methods Totally 120 UAP patients diagnosed and treated in Wuhan Red Cross Hospital,Hubei Province from February 2018 to February 2020 were selected.They were divided into UAP group(62 cases)and UAP+T2DM group(58 cases)according to whether there was T2DM.Enzyme-linked immunosorbent assay was used to detect the levels of serum RLX2 and CNN1 in the two groups.The general clinical data and the levels of serum RLX2 and CNN1 were compared between the two groups.The correlation between serum RLX2,CNN1 and clinical indexes in patients with UAP+T2DM was analyzed.Multivariate Logistic regression analysis was used to analyze the factors influencing the occurrence of UAP+T2DM.The predictive value of serum RLX2 and CNN1 in UAP+T2DM was analyzed by receiver operating characteristic curve.Results The levels of triacylglycerol,fasting plasma glucose(FPG),high-sensitivity C-reactive protein(hs-CRP),Gensini score,RLX2 and CNN1 in UAP+T2DM group were significantly higher than those in UAP group(all P<0.05).Serum RLX2 in UAP+T2DM patients was significantly positively correlated with FPG and hs-CRP,and CNN1 was significantly positively correlated with FPG,hs-CRP and Gensini score(all P<0.05).RLX2(odds ratio=1.347,95%confidence interval:1.085-1.674,P=0.008)and CNN1(odds ratio=2.172,95%confidence interval:1.098-4.296,P=0.007)were independent factors affecting the occurrence of UAP+T2DM.The areas under the curve of serum RLX2 and CNN1 alone and in combination for the prediction of UAP+T2DM were 0.769,0.786,0.875,respectively.The area under the curve of serum RLX2 and CNN1 in combination was significantly higher than that of serum RLX2 and CNN1 alone(Z=3.810,3.509,both P<0.001).Conclusions The expression of serum RLX2 and CNN1 increase in UAP patients with T2DM.Both are independent related factors affecting the occurrence of UAP+T2DM.The combined detection of serum RLX2 and CNN1 has a high predictive value for UAP complicated with T2DM.