血清淀粉样蛋白A、高敏C反应蛋白、一氧化氮与稳定型冠心病不良心血管事件的关系

doi:10.3969/j.issn.1004-583X.2021.01.003

摘要/Abstract

摘要：

目的探讨血清淀粉样蛋白A、高敏C反应蛋白、一氧化氮水平与稳定型冠心病不良心血管事件的关系。方法回顾性选择稳定型冠心病患者161例,并根据1年的随访结果分为A组(发生不良心血管事件,78例)和B组(未发生不良心血管事件,83例),收集分析患者临床资料,分析稳定型冠心病发生不良心血管事件危险因素,观察血清淀粉样蛋白A、高敏C反应蛋白、一氧化氮对稳定型冠心病发生不良心血管事件预测价值。结果 A组糖尿病、高血压发病率明显高于B组(P<0.05)。A组血清淀粉样蛋白A、高敏C反应蛋白明显大于B组,一氧化氮小于B组(P<0.05)。Logistic回归分析结果显示,糖尿病、高血压、血清淀粉样蛋白A、高敏C反应蛋白、一氧化氮是稳定型冠心病发生心血管不良事件的危险因素。血清淀粉样蛋白A、高敏C反应蛋白、一氧化氮预测稳定型冠心病患者发生心血管不良事件的AUC分别为0.603、0.633、0.706,特异度分别为为0.634、0.651、0.680,敏感度分别为0.673、0.665、0.673,联合预测稳定型冠心病患者发生心血管不良事件AUC为0.744,特异度为0.716,敏感度为0.773。结论血清淀粉样蛋白A、高敏C反应蛋白高表达、一氧化氮低表达是稳定型冠心病患者发生心血管不良事件的危险因素,且三者联合预测稳定型冠心病患者发生心血管不良事件的价值较高具有一定的临床价值。

关键词: 冠心病, 血清淀粉样蛋白A, C反应蛋白质, 一氧化氮, 心血管不良事件

Abstract:

Objective To investigate the relationship between serum amyloid A(SAA), high-sensitivity C-reactive protein(hs-CRP), nitric oxide(NO) and adverse cardiovascular events(ACE) in patients with stable coronary heart disease(CHD).Methods 161 patients with stable CHD were selected retrospectively, and were divided into group A (78 cases with ACE) and group B (83 cases without adverse cardiovascular events) based on one-year follow-up results.The clinical data of the patients were collected, the risk factors of ACE in stable CHD were analyzed, and the predictive value of SAA, hs-CRP and NO for ACE in stable CHD was observed.Results The incidence of diabetes and hypertension in group A was significantly higher than that in group B (P<0.05). SAA and hs-CRP in group A were significantly higher than those in group B, and NO was lower than that in group B (P<0.05). Logistic regression analysis showed that diabetes mellitus, hypertension, SAA, hs-CRP, NO were the risk factors of ACE in stable CHD. ROC curve showing the AUC of SAA, hs-CRP and NO in the diagnosis of ACE in patients with stable CHD was 0.603, 0.633 and 0.706 respectively, the specificity was 0.634, 0.651 and 0.680 respectively, the sensitivity was 0.673, 0.665 and 0.673 respectively, the AUC of the three combined diagnosis of cardiovascular adverse events in patients with stable CHD was 0.744, the specificity was 0.716 and the sensitivity was 0.773. Conclusion High expression of SAA, high expression of hs-CRP and low expression of NO are the risk factors of ACE in patients with stable CHD, and the combination of the three factors has a high clinical value in predicting ACE in patients with stable CHD.

Key words: coronary disease, serum amyloid A, C-reactive protein, nitric oxide, cardiovascular adverse events

中图分类号:

R541.1

任玲, 江珊. 血清淀粉样蛋白A、高敏C反应蛋白、一氧化氮与稳定型冠心病不良心血管事件的关系[J]. 临床荟萃, 2021, 36(1): 16-20.

Ren Ling, Jiang Shan. Relationship between serum amyloid A, high sensitive C-reactive protein, nitric oxide and adverse cardiovascular events in patients with stable coronary heart disease[J]. Clinical Focus, 2021, 36(1): 16-20.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.01.003

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I1/16

图/表 4

参考文献 20

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组别	例数	性别(例)		年龄 (岁)	病程 (月)	BMI (kg/m²)	糖尿病(例)		高血压(例)		LVEF (%)
组别	例数	男	女	年龄 (岁)	病程 (月)	BMI (kg/m²)	是	否	是	否	LVEF (%)
A组	78	37	41	67.34±9.68	5.48±1.01	20.56±6.83	42	36	38	40	64.16±8.18
B组	83	40	43	65.94±8.05	5.21±1.19	21.93±8.11	25	58	27	56	65.95±9.56
统计值		0.010		0.778	1.227	0.917	9.320		9.320		1.273
P值		0.903		0.438	0.223	0.361	0.002		0.036		0.205

组别	例数	性别(例)		年龄 (岁)	病程 (月)	BMI (kg/m²)	糖尿病(例)		高血压(例)		LVEF (%)
组别	例数	男	女	年龄 (岁)	病程 (月)	BMI (kg/m²)	是	否	是	否	LVEF (%)
A组	78	37	41	67.34±9.68	5.48±1.01	20.56±6.83	42	36	38	40	64.16±8.18
B组	83	40	43	65.94±8.05	5.21±1.19	21.93±8.11	25	58	27	56	65.95±9.56
统计值		0.010		0.778	1.227	0.917	9.320		9.320		1.273
P值		0.903		0.438	0.223	0.361	0.002		0.036		0.205

组别	例数	同型半胱氨酸 (mmol/L)	胱抑素C (mg/L)	肌钙蛋白T (mg/mL)	淀粉样蛋白A (mg/L)	一氧化氮 (nmol/L)	高敏C反应蛋白(mg/L)	LDL-C (mmol/L)	HDL-C (mmol/L)	TG (mmol/L)
A组	78	15.78±5.13	0.79±0.18	0.48±0.13	62.79±10.42	26.15±7.04	5.48±1.32	3.51±1.16	2.46±0.85	1.53±0.48
B组	83	15.16±4.94	0.83±0.21	0.51±0.16	43.17±8.41	38.67±9.19	4.17±1.14	3.66±1.27	2.51±0.69	4.17±1.14
t值		0.780	1.294	1.301	13.184	9.738	6.751	0.781	0.411	0.243
P值		0.434	0.198	0.195	0.000	0.000	0.000	0.436	0.682	0.809

组别	例数	同型半胱氨酸 (mmol/L)	胱抑素C (mg/L)	肌钙蛋白T (mg/mL)	淀粉样蛋白A (mg/L)	一氧化氮 (nmol/L)	高敏C反应蛋白(mg/L)	LDL-C (mmol/L)	HDL-C (mmol/L)	TG (mmol/L)
A组	78	15.78±5.13	0.79±0.18	0.48±0.13	62.79±10.42	26.15±7.04	5.48±1.32	3.51±1.16	2.46±0.85	1.53±0.48
B组	83	15.16±4.94	0.83±0.21	0.51±0.16	43.17±8.41	38.67±9.19	4.17±1.14	3.66±1.27	2.51±0.69	4.17±1.14
t值		0.780	1.294	1.301	13.184	9.738	6.751	0.781	0.411	0.243
P值		0.434	0.198	0.195	0.000	0.000	0.000	0.436	0.682	0.809

变量	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
变量	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
高血压	0.578	0.187	9.554	0.002	1.782	1.236	2.572
糖尿病	0.411	0.145	8.034	0.004	1.340	1.009	1.780
血清淀粉样蛋白A	0.154	0.561	0.075	0.004	1.241	0.413	3.727
高敏C反应蛋白	0.36	0.114	9.972	0.005	1.461	1.168	1.827
一氧化氮	0.582	0.279	4.351	0.003	1.742	1.008	3.010