血清VASP、ANGPTL4联合血管内超声在冠心病患者冠状动脉斑块易损性评价中的价值研究

Value of Serum VASP and ANGPTL4 Combined with Intravascular Ultrasound in the Prediction of Coronary Plaque Vulnerability in Patients with Coronary Heart Disease

目的分析血清血管扩张刺激磷蛋白(VASP)、血管生成素样蛋白4(ANGPTL4)联合血管内超声对冠状动脉斑块易损性的预测价值。方法选取2019年3月至2022年3月河北省胸科医院收治的98例冠心病患者为研究对象,所有患者均行血管内超声检查,根据检查结果将患者分为稳定斑块组和易损斑块组;血清VASP、ANGPTL4以及二者与血管内超声相关指标的相关性采用Pearson法分析;冠状动脉斑块易损性的影响因素采用Logistic回归分析;血清VASP、ANGPTL4联合血管内超声对冠状动脉斑块易损性的预测价值采用ROC曲线分析。结果易损斑块组斑块负荷和重构指数高于稳定斑块组,血清VASP、ANGPTL4水平低于稳定斑块组,差异有统计学意义(P<0.05)。相关性分析显示,血清VASP与ANGPTL4水平呈正相关(P<0.05),二者与斑块负荷和重构指数呈负相关(P<0.05)。Logistic回归分析显示,VASP、ANGPTL4是冠状动脉斑块易损性的影响因素(P<0.05)。ROC曲线结果显示,血清VASP、ANGPTL4、斑块负荷、重构指数联合预测冠状动脉斑块易损性优于各自单独预测(Z联合vs VASP=2.568、Z联合vs ANGPTL4=2.735、Z联合vs斑块负荷=2.638、Z联合vs重构指数=2.710,P均<0.05)。结论血清VASP、ANGPTL4水平与冠状动脉斑块易损性密切相关,血清VASP、ANGPTL4联合血管内超声可以提高对冠状动脉斑块易损性的评估价值。

Objective To analyse the predictive value of serum vasodilator-stimulated phosphoprotein(VASP)and angiopoietin-like protein 4(ANGPTL4)combined with intravascular ultrasound(IVUS)for coronary plaque vulnerability in patients with coronary heart disease(CHD).Methods Ninety-eight patients with CHD(all of whom underwent IVUS)admitted to Hebei Chest Hospital from March 2019 to March 2022 were selected.And the patients were divided into stable plaque group(n=47)and vulnerable plaque group(n=51)according to the examination results.Pearson's method was used to analyse the correlation between serum VASP and ANGPTL4,and the correlation between the two indicators and the relevant indexes of IVUS.Logistic regression was used to analyse the influencing factors of coronary plaque vulnerability.ROC curve was applied to analyse the predictive value of IVUS combined with serum VASP and ANGPTL4 for coronary plaque vulnerability.Results Compared with the stable plaque group,the vulnerable plaque group exhibited higher plaque load and remodelling index,but lower serum VASP and ANGPTL4 levels,and the differences were statistically significant(P<0.05).Correlation analysis showed that serum VASP and ANGPTL4 levels were positively correlated(P<0.05),and the above two indicators were negatively correlated with plaque load and remodeling index(P<0.05).Logistic regression analysis showed that serum VASP and ANGPTL4 levels were the influencing factors of coronary plaque vulnerability(P<0.05).ROC curve showed that the combined detection of serum VASP,ANGPTL4,plaque load and remodeling index was better than their single detection in predicting coronary plaque vulnerability in patients with CHD(Z combination vs VASP=2.568,Z combination vs ANGPTL4=2.735,Z combination vs plaque load=2.638,Z combination vs remodeling index=2.710,P<0.05).Conclusion Serum VASP and ANGPTL4 levels are closely related to coronary plaque vulnerability.And serum VASP and ANGPTL4 combined with IVUS improves the prediction accuracy of coronary plaque vulnerability in patients with CHD.