冠心病患者外周血网膜素与冠状动脉病变程度的相关性分析

Correlation between peripheral omentin and severity of coronary artery lesions in patients with coronary heart disease

目的探讨冠状动脉粥样硬化性心脏病(CHD)患者外周血网膜素与冠状动脉(冠脉)病变程度的相关性。方法选取2019年2月至2021年2月于沈阳医学院附属第二医院心内科收治的CHD患者80例为研究对象,另选择同期我院健康体检者30例为正常对照组。依据冠脉病变程度将CHD患者分为轻度组(n=26),中度组(n=32)和重度组(n=22)三组,测定各组血清学指标血尿酸(BUA)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)及基质金属蛋白酶9(MMP-9)水平,同时测定网膜素-1(omentin-1)水平,利用Speaman相关性检验评估omentin-1与BUA、Hcy、hs-CRP及MMP-9水平的相关性。制作ROC曲线,评价omentin-1对CHD患者冠脉病变程度的预测效能。结果四组一般资料比较,无统计学差异(P>0.05),具有可比性。血清BUA、Hcy、hs-CRP及MMP-9水平相比,CHD组水平显著高于正常对照组(P<0.05);omentin-1水平相比,CHD组水平显著少于正常对照组(P<0.05);血清BUA、Hcy、hs-CRP及MMP-9水平与omentin-1水平相关性分析后可见前者均与omentin-1水平呈显著负相关(r=-0.707,P<0.001;r=-0.672,P<0.001;r=-0.734,P<0.001;r=-0.745,P<0.001)。ROC曲线下面积为0.814(95%CI:0.720~0.908,P<0.001),约登指数最大值为0.231,对应最佳截断值为3.015,灵敏度为0.511,特异度为0.720。结论CHD患者外周血中BUA、Hcy、hs-CRP及MMP-9水平随冠脉病变程度加重而增加,同时omentin-1含量较健康人群明显减少,两者呈明显负相关,提示omentin-1可作为CHD患者冠脉病变程度的标志物,临床可根据omentin-1的表达水平及时了解患者冠脉病变程度,以便及早治疗。

Objective To discuss the correlation between peripheral omentin and severity of coronary artery lesions in patients with coronary heart disease(CHD).Methods CHD patients(n=80)were chosen into CHD group and at the same time the cases with healthy examinations(n=30)were chose into control group from Department of Cardiology in the Second Affiliated Hospital of Shenyang Medical College from Feb.2019 to Feb.2021.All CHD patients were divided,according to the severity of coronary artery lesions,into mild group(n=26),moderate group(n=32)and severe group(n=22).The levels of blood uric acid(BBUA),homocysteine(Hcy),high sensitivity C-reactive protein(hs-CRP),matrix metalloproteinase 9(MMP-9)and omentin-1 were detected in all groups.The correlation between omentin-1 and levels of BBUA,Hcy,hs-CRP and MMP-9 were reviewed by using Speaman correlation test.A ROC curve was made for reviewing the predictive efficacy of omentin-1 to severity of coronary artery lesions in CHD patients.Results The comparison in general materials showed there no statistical differences among 4 groups(P>0.05).The levels of BUA,Hcy,hs-CRP and MMP-9 were significantly higher in CHD group than those in control group(P<0.05).The level of omentin-1 was significantly lower in CHD group than that in control group(P<0.05).The levels of BUA,Hcy,hs-CRP and MMP-9 were negatively correlated to omentin-1 level(r=-0.707,P<0.001;r=-0.672,P<0.001;r=-0.734,P<0.001;r=-0.745,P<0.001).The area under ROC curve was 0.814(95%CI:0.720~0.908,P<0.001),the maximum Youden index was 0.231,corresponding optimal cutoff value was 3.015,sensitivity was 0.511,and specificity was 0.720.Conclusion The levels of BUA,Hcy,hs-CRP and MMP-9 in peripheral blood will increase and omentin-1 will decrease with the increase of severity of coronary artery lesions in CHD patients compared with healthy people,showing a significant negative correlation,which indicates that omentin-1 can be taken as a biomarker for severity of coronary artery lesions.