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目的:探讨冠心病患者血清淀粉样肽1-40(Aβ1-40)浓度变化及其与冠状动脉(冠脉)病变的关系。方法:选取我院经造影确诊的冠心病患者300例及同期造影为非冠心病患者86例,采集基本临床资料及生化指标,以酶联免疫吸附法(ELISA法)检测Aβ1-40的浓度。Gensini评分判断冠脉病变的严重程度,分析Aβ1-40浓度与冠心病及其严重程度的相关性。结果:与对照组比较,冠心病组血清肌酐[(76.2±18.9)μmol/L∶(69.4±14.3)μmol/L,P<0.001]和Aβ1-40[(63.9±20.14)ng/L∶(55.9±17.1)ng/L,P<0.001]显著增高而高密度脂蛋白[(0.96±0.26)mmol/L∶(1.06±0.33)mmol/L,P<0.003]显著降低。Gensini评分重度(>40)的冠心病患者肌酐、葡萄糖、总胆固醇、低密度脂蛋白及Aβ1-40显著高于轻度(<20)患者(P<0.05)。相关分析显示血清Aβ1-40浓度与年龄、高血压、尿素、肌酐、高密度脂蛋白及Gensini分级等呈显著相关(P<0.05),在校正性别、年龄、高血压、肌酐、尿素及高密度脂蛋白后,Aβ1-40浓度仍与冠心病Gensini分级显著正相关(r=0.113,P=0.027)。结论:冠心病患者血清Aβ1-40显著升高,升高的Aβ1-40与冠心病冠脉Gensini分级显著正相关,提示血清Aβ1-40测定有可能成为临床冠脉病变评估的有效指标。
Objective: To investigate the changes of serum amyloid peptide 1-40 (Aβ1-40) and its relationship with coronary artery (coronary artery) in patients with coronary heart disease. Methods: 300 cases of coronary heart disease diagnosed by contrast-enhanced angiography in our hospital and 86 cases of non-coronary heart disease were enrolled in this study. Basic clinical data and biochemical indexes were collected and the concentration of Aβ1-40 was detected by enzyme-linked immunosorbent assay (ELISA). Gensini score to determine the severity of coronary lesions, analysis of Aβ1-40 concentration and coronary heart disease severity and its relevance. Results: Compared with the control group, serum creatinine [(76.2 ± 18.9) μmol / L and (69.4 ± 14.3) μmol / L, P <0.001 and Aβ1-40 [(63.9 ± 20.14) 55.9 ± 17.1) ng / L, P <0.001], while high-density lipoprotein [(0.96 ± 0.26) mmol / L: (1.06 ± 0.33) mmol / L, P <0.003] Serum creatinine, glucose, total cholesterol, low density lipoprotein, and Aβ1-40 were significantly higher in patients with severe Gensini scores (> 40) than those in mild (<20) patients (P <0.05). Correlation analysis showed that serum Aβ1-40 concentration was significantly correlated with age, hypertension, urea, creatinine, high density lipoprotein and Gensini classification (P <0.05). Correlation analysis of sex, age, hypertension, creatinine, urea and high density After the lipoprotein, the concentration of Aβ1-40 was still significantly and positively correlated with the Gensini grade of coronary heart disease (r = 0.113, P = 0.027). Conclusion: Serum Aβ1-40 in patients with coronary heart disease was significantly increased. The elevated Aβ1-40 was significantly and positively correlated with the Gensini classification of coronary heart disease, suggesting that serum Aβ1-40 may be an effective indicator for the evaluation of clinical coronary artery disease.