冠心病患者血清基质Gla蛋白水平与冠状动脉钙化程度相关性研究

Investigation on correlation between serum matrix gla protein and coronary artery calcification

目的:探讨冠心病患者血清基质Gla蛋白(MGP)水平与冠状动脉钙化(CAC)程度的关系,为冠状动脉钙化的临床诊断和评估提供依据。方法:选择我院2017年5月至2018年4月住院的86例冠心病患者,入院后采集空腹静脉血测定血清MGP水平。应用64排CT进行冠状动脉CT造影,根据冠状动脉CT的Agatston(CACS)法积分将研究对象分为冠脉钙化组(CACS>0)与对照组(CACS=0),冠脉钙化组按CACS值分为少量钙化组(CACS<10分)、轻度钙化组(CACS=10～99.9分)、中度钙化组(CACS=100～399.9分)、重度钙化组(CACS≥400),比较各钙化组与对照组以及不同程度钙化组之间血清MGP水平差异。对血清MGP与冠脉钙化积分等级进行相关性分析。应用Logistic回归分析影响冠状动脉钙化的危险因素。结果:少量钙化组、轻度钙化组与对照组患者血清MGP水平无明显差异[(23.0±3.59)vs(23.6±4.58) nmol·L^(-1),(22.8±4.02)vs(23.6±4.58) nmol·L^(-1),均P>0.05],中度钙化组、重度钙化组血清MGP水平均低于对照组[(16.4±3.78)vs(23.6±4.58) nmol·L^(-1),P<0.05;(11.3±2.96)vs(23.6±4.58) nmol·L^(-1),P<0.01],轻度钙化、中度钙化及重度钙化三组之间血清MGP水平差异有统计学意义(P<0.05)。血清MGP水平与钙化程度呈负相关(r=-0.223,P<0.05)。多变量Logistic回归分析显示,糖尿病、TC、LDL-C、MGP水平均是冠状动脉钙化独立危险因子。结论:血清MGP水平与冠状动脉钙化程度呈负相关,可作为冠状动脉钙化诊断以及程度评估的独立指标。

Objective: To explore the relationship between serum matrix gla protein(MGP) levels and coronary artery calcification(CAC), and to provide evidence for the clinical diagnosis and evaluation of CAC. Methods: A total of 86 patients with coronary heart disease were eligible for this study from May 2017 to April 2018. The levels of serum MGP were determined in their fasting blood samples after admission. CT coronary angiography was performed with a 64-slice CT. According coronary artery calcium score, all patients were divided into calcification group(CACS>0) and control group(CACS=0). According CACS value, calcification group were further divided into four groups: slight calcification group(CACS<10), mild calcification group(CACS=10-99.9), moderate calcification group(CACS=100-399.9), severe calcification group(CACS≥400).The difference of serum MGP levels was compared between the groups, and the correlation between serum MGP levels and the degree of coronary artery calcification were analyzed. Results: There were no significant differences of serum MGP levels between the slight calcification group, the mild calcification group and the control group(23.0±3.59 vs 23.6±4.58 nmol·L-1;22.8±4.02 vs 23.6±4.58 nmol·L-1,P>0.05). The serum level of MGP in the moderate calcification group and severe the calcification group were all lower than that in the control group(16.4±3.78 vs 23.6±4.58 nmol·L-1,P<0.05;11.3±2.96 vs 23.6±4.58 nmol·L-1,P<0.01). There were significant differences of serum MGP levels among the mild calcification group, the moderate calcification group and the severe calcification group(P<0.05). There was a significant negative correlation between MGP levels and coronary artery calcium score(r=-0.023,P<0.05). Multivariate logistic regression analysis showed that the history of diabetes, cholesterol, low density lipoprotein and MGP were the independent risk factors of CAC. Conclusion: Serum MGP negatively correlated with coronary artery calcification,is the independent predictor for diagnosis and assessment of coronary artery calcification degree.