冠心病患者血清鸢尾素、内脂素水平与病变程度的关系

Relationship between serum Irisin and Visfatin levels and the degree of lesion in patients with coronary heart disease

目的通过检测冠心病患者血清中鸢尾素、内脂素水平,分析二者与冠心病及病变程度的关系。方法回顾性选取2018年10月至2020年10月在长江大学附属仙桃市第一人民医院确诊的125例冠心病患者为冠心病组,按照冠状动脉病变程度分为单支病变组(n=54)、双支病变组(n=46)、多支病变组(n=25);同时选取同时间段健康体检者68名为对照组。比较冠心病组和对照组的各项临床资料;酶联免疫吸附试验测定受试者血清鸢尾素、内脂素水平;采用多因素Logistic回归分析影响冠心病的危险因素;采用受试者工作特征(ROC)曲线分析血清鸢尾素、内脂素水平对冠心病及其病变程度的诊断价值。结果冠心病组患者高血压病史患者比率、糖尿病病史患者比率、空腹血糖、低密度脂蛋白胆固醇(LDL-C)、甘油三酯、总胆固醇、N末端脑钠肽前体(NT-proBNP)、血清内脂素水平均显著高于对照组,高密度脂蛋白胆固醇(HDL-C)、左室射血分数(LVEF)、血清鸢尾素水平均显著低于对照组,差异均有统计学意义(P<0.05)。随着冠心病严重程度的增加,Gensini评分、血清内脂素水平、NT-proBNP、LDL-C、甘油三酯、总胆固醇水平升高,血清鸢尾素水平、LVEF、HDL-C降低,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示鸢尾素、内脂素、NT-proBNP、LVEF均是影响冠心病发生的独立因素;ROC曲线结果表明,血清鸢尾素水平诊断冠心病、双支病变和多支病变的曲线下面积(AUC)分别为0.866、0.806、0.988,血清内脂素水平诊断冠心病以及鉴别诊断单支病变和双支病变、双支病变和多支病变的AUC为0.845、0.942、0.894。结论血清鸢尾素、内脂素水平与冠心病病变程度密切相关,病变程度越严重,血清内脂素水平越高,鸢尾素水平越低,二者均可作为冠心病及病变程度的诊断指标。

Objective To detect the expression levels of Irisin and Visfatin in serum of patients with coronary heart disease,and to analyze their relationship with coronary heart disease and the degree of the lesion.Methods From October 2018 to October 2020,125 patients with coronary heart disease admited to Xiantao First People's Hospital of Yangtze University were regarded as the coronary heart disease group.According to the degree of coronary artery disease,they were grouped into single-vessel lesion group(n=54),double-vessel lesion group(n=46)and multi-vessel lesion group(n=25);68 healthy physical examinees in the same time period were selected as the control group.The clinical data between the coronary heart disease group and the control group was compared;the levels of serum Irisin and Visfatin were measured by enzyme-linked immunosorbent assay;the risk factors of coronary heart disease was analyzed by multivariate Logistic regression;the diagnostic value of serum Irisin and Visfatin in coronary heart disease and the degree of lesions was analyzed by receiver operating characteristic(ROC)curve.Results Compared with those in the control group,the hypertension history,diabetes history,fasting blood glucose,low-density lipoprotein cholesterol(LDL-C),triacylglycerol,total cholesterol,N-terminal probrain natriuretic peptide(NT-proBNP),and serum Visfatin level were obviously higher,the high-density lipoprotein cholesterol(HDL-C),left ventricular ejection fraction(LVEF)and serum Irisin level were obviously lower,the differences were statistically significant(P<0.05).With the increase of the severity of coronary heart disease,the Gensini score,serum Visfatin,NT-proBNP,LDL-C,triacylglycerol,and total cholesterol level were higher,while the serum Irisin,LVEF,HDL-C and level were lower,the differences were statistically significant(P<0.05).Multivariate Logistic regression resule showed that Irisin,Visfatin,NT-proBNP and LVEF were independent factors affecting the occurrence of coronary heart disease;ROC curve results showed that the areas under the curve(AUC)of serum Irisin level in the diagnosis of coronary heart disease,double-vessel lesion and multi-vessel lesion were 0.866,0.806,and 0.988,respectively,the AUCs of serum Visfatin level in the diagnosis of coronary heart disease,the differential diagnosis of single-vessel lesion and double-vessel lesion,and the differential diagnosis of double-vessel lesion and multi-vessel lesion were 0.845,0.942,and 0.894,respectively.Conclusion The levels of serum Irisin and Visfatin are closely related to the severity of coronary heart disease.The more serious the lesion,the higher the serum Visfatin level and the lower the Irisin level.Both can be used as diagnostic indicators of coronary heart disease and the degree of lesions.