急性心肌梗死患者血清Aβ1-40、YKL-40水平与冠状动脉病变严重程度的关系分析

The analyse of the relationship between serum Aβ1 -40 and YKL-40 levels and severity of coronaryartery lesions in patients with acute myocardial infarction

目的 分析急性心肌梗死(AMI)患者血清β-淀粉样蛋白1-40(Aβ1-40)、人软骨糖蛋白-39(YKL-40)水平与冠状动脉病变严重程度的关系。方法 选取2019年6月~2020年6月内蒙古自治区人民医院收治的109例AMI患者,根据Gensini积分分为轻度狭窄组(≤24分,37例)、中度狭窄组(25~49分,50例)、重度狭窄组(≥50分,22例)。比较各组患者临床资料、实验指标水平[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、左室射血分数(LVEF)、左室舒张期末内径(LVEDD)]、血清Aβ1-40、YKL-40水平,采用Spearman相关性分析各指标与Gensini积分的相关性,采用logistic回归分析各指标与冠状动脉病变严重程度的相关性。结果 各组吸烟史、饮酒史、TC、HDL、LDL、LVEF比较,差异有统计学意义(P <0.05)。3组间血清Aβ1-40、YKL-40水平两两比较,差异有统计学意义(P <0.05)。Spearman相关性分析结果显示,Gensini积分与HDL、LVEF呈显著负相关(r=-0.325、-0.422,P <0.05),与Aβ1-40、YKL-40呈显著正相关(r=0.456、0.398,P <0.05)。Logistic回归分析,结果显示LVEF、血清Aβ1-40、YKL-40是冠状动脉病变严重程度的影响因素(P <0.05)。结论 AMI患者冠状动脉病变越严重,血清Aβ1-40、YKL-40水平越高,其与Gensini积分呈正相关,是冠状动脉病变严重程度的影响因素。

Objective To analyze the relationship between serumβ-amyloid 1-40(Aβ1-40)and human cartilage glycoprotein-39(YKL-40)levels and the severity of coronary artery lesions in patients with acute myocardial infarction(AMI).Methods A total of 109 patients with AMI admitted to our hospital from June 2019 to June 2020 were selected as the research objects.According to the Gensini score,they were divided into mild stenosis group(≤24 points,n=37)and moderate stenosis group(25~49 points,n=50),severe stenosis group(≥50 points,n=22).Comparison of clinical data of patients in each group and experimental index levels[total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),left ventricular ejection fraction(LVEF),left Ventricular end-diastolic diameter(LVEDD)],serum Aβ1-40,YKL-40 levels.Spearman correlation was used to analyze the correlation between each index and Gensini score,and Logistic regression was used to analyze the correlation between each index and the severity of coronary artery disease.Results There were significant differences in smoking history,drinking history,TC,HDL,LDL,and LVEF(P<0.05).The serum Aβ1-40 and YKL-40 levels were significantly different among the three groups(P<0.05).Gensini score was significantly negatively correlated with HDL and LVEF(P<0.05),and significantly positively correlated with Aβ1-40 and YKL-40(P<0.05).Logistic regression analysis showed that LVEF,serum Aβ1-40 and YKL-40 were the influencing factors of the severity of coronary artery disease(P<0.05).Conclusion In patients with AMI,higher serum Aβ1-40 and YKL-40 levels are associated with more severe the coronary lesions,as indicated by the Gensini score,and are the influencing factors of the severity of coronary lesions.