血清NT-pro-BNP、MMP-2水平与糖尿病合并急性脑梗死患者冠状动脉病变程度的关系

The relationship between serum NT-pro-BNP,MMP-2 levels and the severity of coronary artery disease in patients with diabetes mellitus complicated with acute cerebral infarction

目的探讨血清N末端脑钠肽前体(NT-pro BNP)、基质金属蛋白酶-2(MMP-2)水平与糖尿病合并急性脑梗死(ACI)患者冠状动脉病变程度的关系。方法选择首都医科大学电力教学医院2021年1月—2022年12月收治的126例糖尿病合并ACI患者为观察组,其中单支病变62例,双支病变33例,三支病变31例,轻度狭窄37例,中度狭窄43例,重度狭窄46例。另将同期于我院体检的60例单纯糖尿病患者纳为对照组以及60例健康体检者设为正常组。比较三组心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)、NT-pro BNP、MMP-2、I型胶原交联羧基末端肽(ICTP)水平;以ROC分析NT-pro BNP、MMP-2诊断糖尿病患者并发ACI的价值;比较不同冠状动脉病变支数及不同冠状动脉狭窄程度患者NT-pro BNP、MMP-2、ICTP水平;以Spearman秩相关分析NT-pro BNP、MMP-2、ICTP水平与冠状动脉病变支数、冠状动脉狭窄程度之间的相关性。结果观察组cTnI、CK-MB、NT-pro BNP、MMP-2、ICTP水平显著高于对照组(P<0.05),对照组cTnI、CK-MB、NT-pro BNP、MMP-2、ICTP水平显著高于正常组(P<0.05)。ROC结果显示,NT-pro BNP、MMP-2诊断糖尿病患者并发ACI训练集的曲线下面积为0.953、0.872,测试集的曲线下面积为0.902、0.842(P均<0.05)。NT-pro BNP、MMP-2、ICTP水平随着冠状动脉病变支数的增加及冠状动脉狭窄程度的加重而上升(P<0.05)。NT-proBNP、MMP-2、ICTP水平与糖尿病合并ACI患者冠状动脉病变支数、冠状动脉狭窄程度呈正相关(均有P<0.05)。结论NT-pro BNP、MMP-2、ICTP水平与糖尿病合并ACI患者冠状动脉病变支数、冠状动脉狭窄程度呈正相关,临床关注以上指标可对糖尿病合并ACI患者冠状动脉病变程度进行评估。

Objective To investigate the relationship between the degree of coronary artery lesions in patients with diabetes complicated with acute cerebral infarction(ACI)and the levels of serum NT-pro-BNP and MMP-2.Methods A total of 126 diabetic patients with ACI admitted to our hospital from January 2021 to December 2022 were selected as the observation group,including 62 patients with single-vessel lesion,33 patients with double-vessel lesion,31 patients with three-vessel lesion,37 patients with mild stenosis,43 patients with moderate stenosis,and 46 patients with severe stenosis.In addition,60 patients with simple diabetes who underwent physical examination in our hospital at the same time were included as the control group and 60 healthy people as the normal group.ROC was used to analyze the value of NT-pro BNP and MMP-2 in the diagnosis of ACI in diabetic patients;the levels of NT-pro BNP,MMP-2 and ICTP were compared in patients with different number of coronary artery lesions and different degree of coronary artery stenosis;Spearman rank correlation was used to analyze the correlation between the levels of NT-pro BNP,MMP-2,ICTP and the number of coronary artery lesions and the degree of coronary artery stenosis.Results The levels of cTnI,CK-MB,NT-pro BNP,MMP-2 and ICTP in observation group were significantly higher than those in control group(P<0.05).The levels of cTnI,CK-MB,NT pro BNP,MMP-2,and ICTP in the control group were significantly higher than those in the normal group(P<0.05).ROC results showed that the areas under the curve of the training set and the test set were 0.953 and 0.872,and the areas under the curve of the test set were 0.902 and 0.842,both P<0.05.The levels of NT-pro BNP,MMP-2 and ICTP were increased with the increase of the number of coronary artery lesions and the aggravation of coronary artery stenosis(P<0.05).The levels of NT-pro BNP,MMP-2 and ICTP were positively correlated with the number of coronary artery lesions and the degree of coronary artery stenosis in diabetic patients with ACI(P<0.05).Conclusion The levels of NT-pro BNP,MMP-2 and ICTP are positively correlated with the number of coronary artery lesions and the degree of coronary artery stenosis in diabetic patients with ACI.Clinical attention to the above indicators can be used to evaluate the the degree of coronary artery lesions of diabetic patients with ACI.