缺血性心脏病患者血清对氧磷酶1活性与冠状动脉Gensini评分的关系

Relationship between serum paraoxonase 1 and coronary artery Gensini score in patients with ischemic heart disease

目的探讨缺血性心脏病(IHD)患者血清对氧磷酶1(PON-1)与冠状动脉(冠脉)Gensini评分的关系。方法选择大理市第一人民医院2019年1—11月收治的334例IHD患者作为研究对象,另外选择同期312名健康体检者作为对照组。采用全自动生化仪检测血清中PON-1的活性;采用Pearson线性相关方法分析PON-1活性与冠脉狭窄程度Gensini评分的关系;根据Gensini评分不同,将IHD患者分为轻度狭窄组(Gensini≤60分;254例)和严重狭窄组(Gensini>60分;80例);绘制受试者工作特征曲线(ROC曲线)并计算ROC曲线下面积(AUC),分析PON-1用于筛查严重IHD的诊断效能。结果IHD患者血清PON-1活性明显低于对照组[U/L:115.25(88.50,148.90)比126.40(93.27,161.93),P<0.05]。PON-1活性与冠脉Gensini评分呈负相关(r值为-0.477,P<0.001)。严重狭窄组PON-1活性明显低于轻度狭窄组[U/L:93.95(58.65,124.88)比135.40(102.85,171.00),P<0.001]。ROC曲线分析结果显示,利用PON-1筛查冠脉严重狭窄患者的截断值为116.10 U/L时,AUC为0.738[95%可信区间(95%CI)为0.675~0.802],灵敏度和特异度分别为72.5%、65.9%。结论冠脉Gensini评分与PON-1活性呈负相关,PON-1在严重IHD患者的筛查和诊断中具有一定应用价值。

Objective To investigate the relationship between serum paraoxonase 1(PON-1)and coronary artery Gensini score in patients with ischemic heart disease(IHD).Methods The 334 patients with IHD admitted to the First People's Hospital of Dali from January to November,2019 were selected as research objects,and 312 physical examiners in the same period were selected as control group.The activity of serum PON-1 was detected by automatic biochemical instrument.Pearson linear correlation analysis was used to analyze the correlation between PON-1 activity and coronary artery stenosis Gensini score.According to Gensini scores,IHD patients were divided into mild stenosis group(Gensini score≤60;254 cases)and severe stenosis group(Gensini score>60;80 cases).The receiver operater characteristic(ROC)curve was drawn,the area under ROC curve(AUC)was calculated,and the diagnostic efficiency of PON-1 for screening severe IHD was analyzed.Results The serum PON-1 activity of patients with IHD was lower than that in control group[U/L:115.25(88.50,148.90)vs.126.40(93.27,161.93),P<0.05].PON-1 activity was inversely correlated with Gensini score(r value was-0.477,P<0.001).Serum PON-1 activity was significantly lower in severe stenosis group than that in mild stenosis group[U/L:93.95(58.65,124.88)vs.135.40(102.85,171.00),P<0.001].ROC curve analysis showed that when the cutoff value of PON-1 was 116.10 U/L,the AUC was 0.738[95%confidence interval(95%CI)was 0.675-0.802],and the sensitivity and specificity were 72.5%and 65.9%respectively.Conclusion There is a negative correlation between coronary Gensini score and PON-1 activity,and PON-1 has certain application value in screening and diagnosis of severe IHD patients.