论文部分内容阅读
目的弹性纤维是冠状动脉(简称冠脉)管壁的主要细胞外基质成分,其降解和破坏可能与冠脉扩张的发病直接相关,本研究拟探讨弹性纤维降解产物外周血可溶性弹性蛋白(s Elastin)对冠脉扩张的临床诊断价值。方法在北京协和医院同期进行冠脉造影的人群中,入选冠脉扩张患者、冠心病患者和对照研究对象各60人。利用ELISA方法检测血浆s Elastin含量,并利用ROC曲线分析其诊断冠脉扩张的灵敏度和特异性的分布,在选取最佳截断值后,对其诊断的真实性、可靠性和收益进行综合评价。结果 (1)冠脉扩张组s Elastin显著升高,分别为冠心病组和对照组的1.79倍(P=0.000)和2.03倍(P=0.000);(2)选取最佳截断值为13.693 ng/ml时,s Elastin诊断冠脉扩张的灵敏度为0.800,特异性为0.767;(3)真实性评价:诊断指数为1.567,Youden指数为0.567;(4)可靠性评价:符合率76.67%,Kappa分析有统计学意义(P=0.000);(5)收益分析:阳性预测值为63.2%,阴性预测值为80.7%。结论 s Elastin可以作为辅助诊断冠脉扩张的生物标记物。
Objective Elastic fibers are the main components of the extracellular matrix of the coronary artery wall. Their degradation and destruction may be directly related to the occurrence of coronary artery dilatation. This study was to investigate the expression of sElastin ) On the clinical diagnosis of coronary dilatation value. Methods Peking Union Medical College Hospital coronary angiography in the same period, selected coronary artery dilatation, coronary heart disease patients and control subjects of 60 people. The plasma levels of s Elastin were detected by ELISA. The sensitivity and specificity of the diagnosis of coronary artery dilatation were analyzed by ROC curve analysis. After selecting the best cutoff value, the accuracy, reliability and profit of the diagnosis were evaluated comprehensively. Results (1) The level of slastin in coronary artery dilatation group was significantly higher than that in coronary heart disease group and control group (P = 0.000) and 2.03 times (P = 0.000) respectively. (2) The best cutoff value was 13.693 ng / ml, s Elastin diagnostic accuracy of coronary dilatation of 0.800 and specificity of 0.767; (3) the authenticity of the evaluation: the diagnostic index was 1.567, Youden index was 0.567; (4) reliability evaluation: the coincidence rate of 76.67%, Kappa Analysis was statistically significant (P = 0.000); (5) Income Analysis: Positive predictive value was 63.2%, negative predictive value was 80.7%. Conclusion Elastin can be used as a biomarker to help diagnose coronary dilatation.