Correlation between serum free fatty acids levels and Gensini score in elderly patients with coronary heart disease

Objectives To investigate the relationship between serum fxee fatty acids （FFAs） levels and the severity of coronary artery lesions in elderly patients with coronary heart disease （CAD）. Methods A total of 172 elderly patients who underwent coronary angiography were divided into CAD group （n = 128） and non-CAD group （n = 44） according to the results of coronary angiography. Serum FFAs and lipid levels were measured and the Gensini score were calculated. Results No matter the differences between age, gender and the usage of stat- ins or not, there was no statistical significance in FFAs levels （P 〉 0.05）. In terms of the Gensini score, it was higher in patients aged 70-79 years than in patients 60-69 years old [15.00 （5.00, 34.00） vs. 10.00 （2.00, 24.00）, P 〈 0.05], higher in men than women [14.00 （4.00, 34.00） vs. 7.00 （2.50, 19.75）, P 〈 0.05], and higher in patients on statins [13.50 （4.25, 33.50）vs. 6.50 （2.00, 18.00）, P 〈 0.05]. The serum FFAs lev- els [449.50 （299.00, 624.75） mEq/L vs. 388.00 （258.50, 495.25） mEq/L, P 〈 0.05J and Gensini score [17.50 （8.00, 41.75） vs. 1.00 （0, 5.00）, P 〈 0.05] were higher in the CAD group than in the non-CAD group. In the CAD group, there was no statistical significance in FFAs levels among patients with different numbers of diseased coronary vessels （P 〉 0.05）. Furthermore, the FFAs levels were positively correlated with the Gensini score （r = 0.394, P = 0.005）. Regression analysis showed that the FFAs levels were related to the Gensini score independently after adjusting for the other risk factors. Conclusions The serum FFAs levels were associated with the Gensini score in elderly patients with CAD. It might indicate FFAs as a biomarker predicting the severity of coronary artery lesions.

Correlation between Neutrophil Percentage-to-albumin Ratio and Coronary Heart Disease Complicated with Diabetes Mellitus

[Objectives]This study was conducted to explore the relationship between neutrophil percentage-to-albumin ratio(NPAR)and coronary heart disease complicated with diabetes.[Methods]A total of 603 patients with coronary heart disease who underwent coronary angiography in Pingquan County Hospital from January,2023 to December,2023 and met the inclusion criteria were included as the research object.All the patients were divided into a coronary heart disease complicated with diabetes group(CAD+T2DM group)(n=298 cases)and a control group(CAD group)(n=305 cases),according to patients medical history,heart color ultrasound and biochemical test results.The clinical data,biochemical test results and coronary artery imaging data of patients were recorded,and the Gensini score was calculated.The neutrophil percentage(NEUT%)and albumin count were determined to calculate NPAR.[Results]The NPAR value of the coronary heart disease complicated with diabetes mellitus group was(1.6±0.42),which was significantly higher than that of the control group(1.47±0.49),and the difference was statistically significant(P<0.05).The area under the ROC curve was 0.619(95%CI:0.591-0.675,P<0.05),and the prediction of coronary heart disease complicated with diabetes using NPAR showed a Youden index of 0.31,a sensitivity of 60.4%,a specificity of 40.3%,and a best cut-off score of 1.4506.[Conclusions]The neutrophil percentage-to-albumin ratio(NPAR)is closely related to coronary heart disease complicated with diabetes mellitus,and NPAR has clinical application value in the diagnosis of coronary heart disease complicated with diabetes mellitus.

Application of SYNTAX and its Derivative Scores in the Selection of Revascularization Strategies for Complex Coronary Heart Disease

Complex coronary heart disease(CHD)has become a hot spot in medicine due to its complex coronary anatomy,variable clinical factors,difficult hemodynamic reconstruction,and limited effect of conservative drug treatment.Identifying complex CHD and selecting optimal treatment methods have become more scientific as revascularization technology has improved,and coronary risk stratification scores have been introduced.SYNTAX and its derivative scores are decision-making tools that quantitatively describe the characteristics of coronary lesions in patients based on their complexity and severity.The SYNTAX and its derivative scores could assist clinicians in rationalizing the selection of hemodynamic reconstruction treatment strategies,and have demon-strated outstanding value in evaluating the prognosis of patients with complex CHD undergoing revascularization treatment.The authors in this article summary the practical application of SYNTAX and its derivative scores in complex CHD in order to deepen the understanding of the relationship between the choice of different revascularization strategies and SYNTAX and its derived scores in complex CHD and provide a further reference for clinical treatment of complex CHD.

Correlation of coronary CTA calcification score with serum inflammatory factors and plaque stability-related indexes in patients with coronary heart disease

Objective: To investigate the correlation of coronary CTA calcification score (CACS) with serum inflammatory factors and plaque stability-related indexes in patients with coronary heart disease. Methods: A total of 228 patients with possible coronary heart disease who were examined in this hospital between November 2014 and March 2017 were selected, and the CACS levels as well as the serum contents of inflammatory factors and plaque stability indexes in patients with different lesions were determined. Pearson test was used to assess the correlation between CACS level and disease severity in patients with coronary heart disease. Results: The CACS level of triple vessel disease group was higher than that of double vessel disease group and single vessel disease group, and the CACS level of double vessel disease group was higher than that of single vessel disease group;serum sICAM-1, IL-6, IL-18, CRP, PTX3, Lp-PLA2 and Cat K contents were higher than those of double vessel disease group and single vessel disease group;serum sICAM-1, IL-6, IL-18, CRP, PTX3, Lp-PLA2 and Cat K contents of double vessel disease group were higher than those of single vessel disease group;serum Cys C content of triple vessel disease group was lower than that of double vessel disease group and single vessel disease group, and serum Cys C content of double vessel disease group was lower than that of single vessel disease group. Pearson test showed that the CACS level in patients with coronary heart disease was directly correlated with serum contents of inflammatory factors and plaque stability indexes. Conclusion: The CACS levels in patients with coronary heart disease increase with the aggravation of disease, and the specific CACS level is directly correlated with the degree of inflammatory response and the stability of the plaques.

Is the ratio of apoB/apoA-1 the best predictor for the severity of coronary artery lesions in Chinese diabetics with stable angina pectoris？ An assessment based on Gensini scores

Background There is a paucity of data about the best lipid ratio predicting the severity of coronary artery disease （CAD） in patients with diabetes mellitus. We determined the relationship between five conventional lipid ratios and the extent of coronary artery lesions in Chinese Type 2 diabetics with stable angina pectoris （SAP）. Methods A prospective cohort study within 373 type 2 diabetic patients diag- nosed with stable CAD by coronary angiography was performed. All patients were classified into three groups according to the tertiles of Gensini scores （GS, low group 〈 8 points n = 143; intermediate group 8-28 points, n = 109; high group 〉 28 points, n = 121）. Association between the ratios of apolipoprotein （apo） B and apoA-1, total cholesterol and high density lipoprotein cholesterol （TC/HDL-C）, triglycerides and HDL-C （TG/HDL-C）, low density lipoprotein cholesterol and HDL-C （LDL-C/HDL-C）, Non-HDL-C/HDL-C and GS were evaluated using the receivers operating characteristic （ROC） curves and multivariate logistic regression models. Results The ratio of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C, and Non-HDL-C/HDL-C were correlated with Gensini scores. Area under the ROC curves for predicting high Gensini scores in the ratios of apoB/apoA-1, TC/HDL-C, LDL-C/HDL-C and Non-HDL-C/HDL-C were 0.62, 0.60, 0.59 and 0.60, respec- tively （P 〈 0.005 for all）. According to multivariate logistic regression analysis after adjusted with demographic characteristic and other lipid parameters, the ratio of apoB/apoA-1 is qualified as an independent discriminator for the severity of CAD. However, after fiu-ther adjusting different baseline variables, such as left ventricular ejective fraction, hemoglobin Alc, leukocytes count and serum creatinine, none of the above lipid ratios remained. Conclusions Compared with other lipid parameters, the ratio of apoB/apoA-1 appears to be more significantly correlated with the extent of coronary artery lesions in Chinese diabetics, but it was not an independent predictor in these settings.

Free triiodothyronine in relation to coronary severity at different ages： Gensini score assessment in 4206 euthyroid patients

Objective To study whether free triiodothyronine （FT3） within normal range has effects on the presence and severity of coronary ar- tery disease （CAD） in different gender and age groups. Methods A total of 4206 euthyroid patients were consecutively enrolled and di- vided into CAD group （n = 3306） and non-CAD group （n = 900）. All patients underwent coronary angiography （CAG）. Gensini score （GS） was used to determine the severity of coronary artery stenosis. Severe CAD was defined as GS 〉 32 and mild CAD was defined as GS 〈 32. Logistic regression analysis and linear regression analysis were conducted to determine the association of FT3 with CAD in patients with different gender and ages. Results Concentration of FT3 was lower in patients with CAD than that in angiography-normal control group （P 〈 0.05）. In addition, concentration of FT3 was lower in severe CAD than that in mild CAD. After adjusting for traditional cardiovascular risk factors and potential confounders, FT3 was negatively correlated with the presence of CAD, but not in the old patients （〉 65 years old）. Mul- tivariable linear regression analysis showed that FT3 was negatively associated with GS in male and young patients with stable CAD, but not in the old patients. Conclusions Low FT3 within normal range was negatively associated with the presence and severity of CAD in young patients, but not in the old ones. Further studies are needed to confirm our findings.

Correlation between betatrophin/angiogenin-likeprotein3/lipoprotein lipase pathway and severity of coronary artery disease in Kazakh patients with coronary heart disease

BACKGROUND The results of previous animal experiments and clinical studies have shown that there is a correlation between expression of betatrophin and blood lipid levels.However,there are still differences studies on the correlation and interaction mechanism between betatrophin,angiogenin-likeprotein3(ANGPTL3)and lipoprotein lipase(LPL).In our previous studies,we found an increase in serum ANGPTL3 Levels in Chinese patients with coronary heart disease(CHD).Therefore,we retrospectively studied Kazakh CHD patients.AIM To explore the correlation between the betatrophin/ANGPTL3/LPL pathway and severity of coronary artery disease(CAD)in patients with CHD.METHODS Nondiabetic patients diagnosed with CHD were selected as the case group;79 were of Kazakh descent and 72 were of Han descent.The control groups comprised of 61 Kazakh and 65 Han individuals.The serum levels of betatrophin and LPL were detected by enzyme-linked immunosorbent assay(ELISA),and the double antibody sandwich ELISA was used to detect serum level of ANGPTL3.The levels of triglycerides,total cholesterol,and fasting blood glucose in each group were determined by an automatic biochemical analyzer.At the same time,the clinical baseline data of patients in each group were included.RESULTS Betatrophin,ANGPTL3 and LPL levels of Kazakh patients were significantly higher than those of Han patients(P=0.031,0.038,0.021 respectively).There was a positive correlation between the Gensini score and total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),betatrophin,and LPL in Kazakh patients(r=0.204,0.453,0.352,0.471,and 0.382 respectively),(P=0.043,0.009,0.048,0.001,and P<0.001 respectively).A positive correlation was found between the Gensini score and body mass index(BMI),TC,TG,LDL-C,LPL,betatrophin in Han patients(r=0.438,0.195,0.296,0.357,0.328,and 0.446 respectively),(P=0.044,0.026,0.003,0.20,0.004,and P<0.001).TG and betatrophin were the risk factors of coronary artery disease in Kazakh patients,while BMI and betatrophin were the risk factors in Han patients.CONCLUSION There was a correlation between the betatrophin/ANGPTL3/LPL pathway and severity of CAD in patients with CHD.

Research on the changes and significance of serum RBP4 level in patients with senior coronary heart disease accompanying diabetes mellitus

Objective:To explore the significance of serum Retinol binding protein 4(RBP4)and its relationship with coronary artery lesion in patients with senior coronary heart disease accompanying T2DM by determining the level of serum RBP4 and Gensini score.Methods:30 cases of patients who were 60 years old above with coronary heart disease accompanying T2DM were selected and included in the experimental group,and 30 cases of patients of 60 years old above with coronary heart disease alone were included in the control group.Both groups of patients were given CAG examinations.In addition,Gensini score was calculated according to different degrees and parts of coronary artery lesion.It was required to record each patient’s age,gender,fasting blood glucose(FPG),triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),glycated hemoglobin(HbA1c)and other laboratory examination indexes.ELISA was used to detect the level of serum RBP4 in each group,and statistical analysis was performed to the data in each group.Results:(1)RBP4 level,GS score,FPG and LDL-C in the experimental group were all higher than those in the control group,and the difference was of statistical significance(p<.05).There was no statistically significant difference in age,gender,TC,TG and HDL-C between two groups.(2)RBP4 was positively correlated to FPG and HbA1c.(3)In patients with senior coronary heart disease accompanying diabetes mellitus,HbA1c was positively correlated to GS score,RBP4 and FPG.(4)RBP4 was a risk factor for coronary artery stenosis in patients with senior coronary heart disease accompanying diabetes mellitus.Conclusions:The level of serum RBP4 in patients with senior coronary heart disease accompanying diabetes mellitus is higher than that in patients with coronary heart disease alone,with a deeper degree of coronary artery lesion.The level of serum RBP4 is increased with the degree of lesion deepened in patients with senior coronary heart disease,suggesting that the level of serum RBP4 is expected to be an early predictor of coronary artery lesion for patients with senior coronary heart disease.

Computed tomography coronary angiography after excluding myocardial infarction:high-sensitivity troponin versus risk score-guided approach

BACKGROUND:Patients with suspected acute coronary syndrome (ACS) in whom myocardial infarction has been ruled out are still at risk of having obstructive coronary artery disease (CAD).This rate is higher among patients with intermediate high-sensitivity troponin I (hsTnI) concentrations (5 ng/L to 99th percentile) than low concentrations (<5 ng/L).Therefore,an intermediate concentration has been suggested as a candidate for downstream investigation with computed tomography coronary angiography(CTCA).We tried to compare the HEART score-guided vs.hsTnI-guided approach for identifying obstructive CAD.METHODS:From a prospective cohort study of patients presenting to the emergency department with suspected ACS,433 patients without elevated hsTnI who also underwent CTCA were selected and analyzed.The performances of hsTnI concentration and HEART score were compared using sensitivity,specificity,positive predictive value (PPV),and negative predictive value (NPV).RESULTS:Overall,120 (27.7%) patients had obstructive CAD.Patients with intermediate hsTnI concentrations were more likely to have obstructive CAD than those with low hsTnI concentrations(40.0%vs.18.1%);patients with non-low-risk HEART scores (≥4 points) were also more likely to have obstructive CAD than those with low-risk scores (0 to 3 points)(41.0%vs.7.6%).The HEART score had higher sensitivity and NPV for detecting obstructive CAD in each classification than hsTnI concentration (sensitivity:89.2%vs.63.3%;NPV:92.4%vs.81.9%,respectively).CONCLUSION:After excluding myocardial infarction in patients with suspected ACS,adding the HEART score for selecting candidates for CTCA could improve patient risk stratification more accurately than relying on hsTnI concentration.

Prediction of presence and severity of coronary artery disease using prediction for atherosclerotic cardiovascular disease risk in China scoring system

BACKGROUND Coronary artery disease(CAD)is one of the leading causes of death and disease burden in China and worldwide.A practical and reliable prediction scoring system for CAD risk and severity evaluation is urgently needed for primary prevention.AIM To examine whether the prediction for atherosclerotic cardiovascular disease risk in China(China-PAR)scoring system could be used for this purpose.METHODS A total of 6813 consecutive patients who underwent diagnostic coronary angiography were enrolled.The China-PAR score was calculated for each patient and CAD severity was assessed by the Gensini score(GS).RESULTS Correlation analysis demonstrated a significant relationship between China-PAR and GS(r=0.266,P<0.001).In receiver operating characteristic curve analysis,the cut-off values of China-PAR for predicting the presence and the severity of CAD were 7.55%with a sensitivity of 55.8%and specificity of 71.8%[area under the curve(AUC)=0.693,95%confidence interval:0.681 to 0.706,P<0.001],and 7.45%with a sensitivity of 58.8%and specificity of 67.2%(AUC=0.680,95%confidence interval:0.665 to 0.694,P<0.001),respectively.CONCLUSION The China-PAR scoring system may be useful in predicting the presence and severity of CAD.

睡眠质量对2型糖尿病患者冠状动脉Gensini评分的影响

目的探究2型糖尿病患者睡眠质量与冠状动脉Gensini评分之间的相关性。方法纳入2022年1月—2023年8月就诊于兰州大学第一医院内分泌科的2型糖尿病患者320例,根据匹兹堡睡眠质量指数(PSQI)量表计算得出的PSQI评分将研究对象分成4组:[0,7]、[8,11]、[12,16]和[17,21]分组,收集一般临床资料,采用Gensini评分评价冠状动脉疾病的严重程度。采用多元线性回归分析2型糖尿病患者Gensini评分的影响因素。结果比较4组患者临床基线资料,发现随着PSQI评分的升高,Gensini评分明显升高,差异具有统计学意义(P<0.001)。多元线性回归分析表明,PSQI评分、男性和低密度脂蛋白胆固醇正向影响2型糖尿病患者冠状动脉Gensini评分,总胆固醇负向影响2型糖尿病患者Gensini评分。结论2型糖尿病患者PSQI评分正向影响Gensini评分,PSQI评分、男性、低密度脂蛋白胆固醇和总胆固醇是冠状动脉疾病的独立危险因素,PSQI评分对部分2型糖尿病患者冠状动脉疾病的发生发展有一定的预测价值。

青年急性冠脉综合征患者PCI术后发生MACE的影响因素及其与Gensini积分的关系

目的 分析青年急性冠脉综合征(ACS)患者经皮冠脉介入术(PCI)后发生主要心血管不良事件(MACE)的影响因素及其与Gensini积分的关系。方法 选取信阳市中心医院2021年6月至2022年6月收治的198例青年ACS患者作为研究对象,均接受PCI,术后随访1 a, 6例失访,共192例完成随访,并记录MACE发生情况。根据是否发生MACE分为MACE组(35例)、非MACE组(157例),收集一般资料及Gensini积分并进行对比,分析影响疾病转归的因素、Gensini积分与疾病转归相关性。结果 两组高血压、支架直径、植入支架个数、心肌肌钙蛋白I(cTnI)、肥胖、肌酸激酶同工酶MB(CK-MB)、同型半胱氨酸(HCY)、Gensini积分比较,差异有统计学意义(P<0.05);多因素分析显示,植入支架个数>1个、cTnI≥8.76μg·L^(-1)、CK-MB≥25.93 U·L^(-1)、HCY≥12.55μmol·L^(-1)、Gensini积分≥13.85分为青年ACS患者PCI后发生MACE的危险因素,支架直径≥3.07 mm为青年ACS患者PCI后发生MACE的保护因素(P<0.05);植入支架个数、cTnI、CK-MB、Gensini积分与疾病转归呈正相关,支架直径与疾病转归呈负相关(P<0.05)。结论 青年ACS患者PCI术后发生MACE受多个因素影响,且植入支架个数、支架直径、cTnI、CK-MB、HCY、Gensini积分与疾病转归存在直接关联性,可为临床制定早期防治措施起到指导作用。

血小板活化因子在各型冠心病中的表达及与冠脉Gensini积分的相关性研究

目的探讨血浆血小板活化因子(PAF)在各型冠心病(CHD)中的表达水平及其与冠脉Gensini积分的相关性。方法选择2012年7—12月因疑似冠心病在郑州大学第一附属医院住院并行冠脉造影术(CAG)者140例,依据冠心病的诊断标准,将其分为冠心病组(108例)和对照组(32例);冠心病组再分为急性心肌梗死(AMI)组(30例)、不稳定型心绞痛(UAP)组(41例)及稳定型心绞痛(SAP)组(37例)。采用双抗体夹心酶联免疫吸附法(ELISA)测定PAF水平,以Gensini积分评价冠脉病变严重程度。比较不同组间PAF水平,分析PAF水平与Gensini积分的相关性。结果对照组、冠心病组的PAF水平分别为(6.27±1.35)、(12.26±2.02)μg/L,两组间比较差异有统计学意义(P<0.05)。SAP组、UAP组、AMI组的PAF水平分别为(10.61±1.97)、(13.01±1.48)、(13.31±1.36)μg/L,3组间差异有统计学意义(P<0.05),亚组间两两比较显示:UAP组、AMI组与SAP组间差异均有统计学意义(P<0.05),UAP组与AMI组间差异无统计学意义(P>0.05)。相关性分析显示,PAF水平与Gensini积分呈正相关(r=0.642,P<0.05)。结论血浆PAF水平在不同类型冠心病间存在差异,与冠状动脉Gensini积分之间存在相关性,可作为评估冠心病的指标。

冠心病患者血清γ-谷氨酰转肽酶水平与Gensini评分的相关性研究

目的探讨冠心病患者血清γ-谷氨酰转肽酶(GGT)水平与Gensini评分的相关性。方法选择2012年2月—2012年12月在唐山市工人医院心内一科住院行冠状动脉造影检查并确诊的冠心病患者190例。根据GGT四分位数将患者分为4组〔第1四分位组(GGT≤17 U/L)、第2四分位组(17 U/L<GGT≤22 U/L)、第3四分位组(22 U/L<GGT≤30 U/L)、第4四分位组(>30 U/L)〕,对各变量进行趋势分析;收集患者临床资料,进行相关生化检查,行冠状动脉造影术并进行Gensini评分。结果 4组年龄、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、肌酐(Cr)、尿酸(UA)、Gensini评分、行经皮冠状动脉介入治疗(PCI)手术率、吸烟率比较,差异均有统计学意义(P<0.05)。第4四分位组TC、LDL-C、Cr、UA、Gensini评分高于第1四分位组和第2四分位组(P<0.05);第3四分位组TC、Gensini评分高于第1四分位组和第2四分位组(P<0.05)。血清GGT水平与Gensini评分、年龄、TC、TG、LDL-C、Cr、UA水平呈正相关,与高密度脂蛋白胆固醇(HDL-C)呈负相关(P<0.05)。多元线性回归分析显示,Gensini评分的升高与血清GGT水平的升高存在剂量-反应关系,在校正冠心病相关危险因素后,冠状动脉Gensini评分均进入回归方程,随血清GGT水平的升高而增加(P<0.05)。结论校正冠心病相关危险因素后,血清GGT水平与Gensini评分呈正相关,血清GGT水平升高可能是冠心病的危险因素,为临床进一步研究提供了理论依据。

未经血运重建的冠心病Gensini评分与血瘀证的相关性研究

目的探讨冠心病(CHD)冠脉造影(CAG)Gensini评分与血瘀证的相关性。方法选取209例经CAG确诊的CHD患者,记录其中医证候与血瘀证计分,并根据CAG结果行Gensini评分,分析其与CHD血瘀证计分及中医证候分布之间的相关性。结果 CHD患者以血瘀证、痰浊证、气虚证最为多见,分别为144例(68.9%)、93例(44.5%)、74例(35.4%)。血瘀证患者冠状动脉最重狭窄和Gensini评分均高于非血瘀患者(P<0.05),痰浊患者的Gensini评分较非痰浊患者严重(P<0.05),其余证型比较,差异均无统计学意义。CHD血瘀证计分与Gensini评分呈正相关(Pearson相关系数为0.68,P=0.012 8)。结论 CHD患者血瘀证计分与冠状动脉病变严重程度呈正相关。

老年冠心病患者外周血T淋巴细胞亚群与冠状动脉Gensini评分的关系及意义

目的：探讨老年冠心病（CHD）患者外周血 T 淋巴细胞亚群与冠状动脉 Gensini 评分及与冠状动脉粥样硬化（AS）病变程度的关系。方法将52例 CHD 患者根据冠状动脉 Gensini 评分结果分为 A 组（5～20分，17例）、B组（21～40分，20例）和 C 组（＞40分，15例）。采用流式细胞分析仪测定3组白细胞分化抗原分化群（CD）3＋、CD4＋、CD8＋ T 淋巴细胞百分率及 CD4＋／CD8＋比值，评价各组间差异，并对外周血 T 淋巴细胞亚群与冠状 AS 病变程度（冠状动脉 Gensini 评分）进行相关性分析。结果与 A 组比较，B、C 2组 CD3＋、CD4＋ T 淋巴细胞百分率及CD4＋／CD8＋比值均明显升高（均 P ＜0．05）；与 B 组比较，C 组 CD4＋ T 淋巴细胞百分率明显升高（P ＜0．05）。CD4＋ T 淋巴细胞百分率、CD4＋／CD8＋比值与冠状动脉 Gensini 评分均呈正相关（r＝0．702、0．472，均 P ＜0．05）。结论老年 CHD 患者冠状 AS 病变严重程度与 CD4＋ T 淋巴细胞水平有关，检测其水平有助于临床病情判断。

血脂及止凝血水平与冠心病患者Gensini积分相关性的研究

目的探讨冠心病患者入院时,血脂及止凝血参数与冠状动脉病变程度Gensini积分的之间的相关性。方法连续入选安徽医科大学第一附属医院心血管内科2016年12月~2018年3月诊断为急性冠脉综合征,通过冠状动脉造影术证实冠心病的患者60例。检测所有患者血脂、止凝血及冠状动脉造影Gensini评分。根据冠状动脉造影Gensini评分分值为两组:冠状动脉造影Gensini积分≤42分组和冠状动脉造影Gensini积分>42分组。结果 TC、n-HDL、LDL-C、APOA、APOB、PT-%与冠状动脉病变Gensini积分明显正相关,相关系数分别为0.426、0.356、0.344、0.267、0.376、0.269(P<0.05);冠状动脉造影Gensini积分>42分组的TC、PT-%明显高于冠状动脉造影Gensini积分≤42分组(P<0.05),而两组患者性别、年龄、合并高血压病、糖尿病、TG、HDL-C、n-HDL、VLDL、LDL-C、APOA、APOB、LP(a)、PT-SEC、PT-INR、APTT-SEC、FIB-G/L、TT-SEC、D-D、FDP均无明显统计学差异(P均>0.05)。结论TC、n-HDL、LDL-C、APOA、APOB、PT-%与冠心病患者冠状动脉病变程度明显正相关,且TC、LDL-C、n-HDL、APOB及LP(a)越高冠状动脉病变越重。

冠心病患者胱抑素C水平与冠状动脉造影Gensini评分的相关性

目的探讨血清胱抑素C水平(CysC)对冠心病患者冠状动脉病变的临床预测价值。方法回顾性分析对261例疑诊为冠心病的患者进行冠状动脉造影(CAG),根据结果分为冠心病组及非冠心病组。测定所有入选者的空腹血糖(FPG),餐后2h血糖(2hPG),三酰甘油(TG),胆固醇(TC),肌酐(Cr),高敏C-反应蛋白(hs-CRP),CysC,高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C),分析CysC与冠心病之间的关系,同时分析冠心病组患者CysC与冠状动脉造影Gensini评分的相关性。结果冠心病组CysC水平较非冠心病组升高,差异有统计学意义(P<0.01);同时发现冠心病患者CysC与其冠状动脉病变Gensini评分呈正相关(r=0.67,P<0.01),logistic回归分析剔除年龄、性别、总胆固醇等因素后,此相关性仍存在(r=0.70,P<0.01)。结论冠心病患者CysC水平与增高,且与冠心病的病情程度有密切关系,随着CysC水平的升高,冠心病患者病情逐渐加重。

冠心病患者内皮祖细胞功能和基质细胞衍生因子1α与冠状动脉Gensini评分的相关性

目的分析冠心病患者循环内皮祖细胞(EPC)功能和基质细胞衍生因子1α(SDF-1α)与冠状动脉病变严重程度的相关性。方法选择经冠状动脉造影证实的冠心病患者80例为冠心病组,排除冠状动脉狭窄的60例为对照组。冠心病组根据Gensini评分标准对冠状动脉病变严重程度进行评分,分为3个亚组。采集研究对象外周血进行分离培养。用噻唑蓝法评价EPC活性,趋化试验评价EPC趋化能力;采用酶联免疫吸附法测定血清SDF-1α水平。结果 (1)冠心病组循环EPC活性和趋化能力明显低于对照组(P<0.01或P<0.05),随着病变程度加重,细胞活性及趋化能力有明显下降趋势。(2)冠心病组血清SDF-1α水平明显低于对照组(P<0.01),重度狭窄组血清SDF-1α水平明显低于轻度狭窄组(P<0.01)。(3)直线相关分析显示,EPC活性、趋化能力、血清SDF-1α水平随Gensini评分的增高而下降,呈负相关(r=-0.224,P<0.05;r=-0.39,P<0.05;r=-0.31,P<0.05)。血清SDF-1α水平随细胞趋化能力的降低而降低,呈正相关(r=0.38,P<0.05)。结论冠心病患者EPC功能及血清SDF-1α水平明显下降,冠状动脉病变程度越重,EPC活性、趋化能力越低。血清SDF-1α水平下降与EPC趋化能力减退具有一致性。

冠心病患者血管性血友病因子裂解酶水平与GRACE评分及Gensini积分的相关性分析

目的:检测冠心病患者外周血血管性血友病因子裂解酶(von Willebrand factor-cleaving protease,vWF-cp)的水平变化以及联合全球急性冠脉注册事件(Global Registry of Acute Coronary Events,GRACE)评分观察对冠心病危险分层的评估价值。方法:选取冠心病患者96例,其中稳定性心绞痛组(stable angina pectoris,SAP)47例,急性冠脉综合征组(acute coronary syndrome,ACS)49例;同时选取同期无血管病变的非冠心病患者49例作为对照组,采用GRACE系统进行评分及分层,同时利用Gensini评分系统评定冠状动脉狭窄程度,用酶联免疫吸附法(enzyme-linked immuno sorbent assay,ELISA)测定外周血vWF-cp的浓度。结果:对照组的vWF-CP水平明显高于ACS组(P=0.000),亦明显高于SAP组(P=0.000),ACS组与SAP组相比,差异有统计学意义(P=0.023);ACS组GRACE评分明显高于对照组(P=0.000),SAP组亦明显高于对照组(P=0.008),ACS组与SAP组相比,ACS组明显升高,差异有统计学意义(P=0.033);不同Gensini积分的冠心病患者的vWF-cp水平比较,差异无统计学意义(P>0.05)。冠心病患者Gensini积分等级与vWF-cp水平无明显相关性(r=0.060,P=0.616)(采用Spearman’s rho法)。GRACE评分等级与vWF-cp水平呈负相关(r=-0.672,P=0.000)(采用Spearman’s rho法)。结论:GRACE评分联合vWF-cp可以在临床上更准确、有效的预测冠心病患者的风险及预后。