纤维胶凝蛋白与冠状动脉狭窄程度相关性及其对预后的影响

doi:10.11958/20221707

摘要/Abstract

摘要：

目的探讨纤维胶凝蛋白-2（Ficolin-2）、纤维胶凝蛋白-3（Ficolin-3）与冠心病患者冠状动脉狭窄程度的相关性及其对预后的影响。方法以137例稳定期冠心病患者为冠心病组，根据Gensini评分分为轻度组56例、中度组49例、重度组32例；根据患者3个月内是否出现主要不良心脏事件（MACEs）分为预后良好组108例和预后不良组29例。选取同期60例健康体检者为对照组。收集各组临床病历资料，检测血清Ficolin-2、Ficolin-3水平，Pearson积矩相关分析其与Gensini的相关性，Logistic回归分析预后不良的影响因素，受试者工作特征（ROC）曲线评估血清Ficolin-2、Ficolin-3对预后不良的预测价值。结果冠心病组血清Ficolin-2、Ficolin-3水平低于对照组（P<0.05）。轻、中、重度组血清Ficolin-2、Ficolin-3水平依次降低（P<0.05）。血清Ficolin-2、Ficolin-3与冠心病患者Gensini评分呈负相关（r分别为-0.708和-0.722，P<0.05）。冠状动脉多支病变[OR（95%CI）：1.451（1.292~1.628）]是冠心病患者预后不良的独立危险因素，较高水平Ficolin-2、Ficolin-3是独立保护因素，OR（95%CI）分别为0.815（0.730~0.909）和0.853（0.787~0.924）。Ficolin-2与Ficolin-3指标联合预测冠心病患者预后不良的AUC高于单一指标（Z分别为3.186和2.953，P<0.05）。结论冠心病患者血清Ficolin-2、Ficolin-3水平降低，并且与冠状动脉狭窄程度呈负相关，两指标联合检测可预测冠心病患者预后不良，敏感度较高。

关键词: 冠心病, 冠状动脉狭窄, 敏感性与特异性, 纤维胶凝蛋白-2, 纤维胶凝蛋白-3, 主要不良心脏事件

Abstract:

Objective To investigate the correlation between Ficolin-2, Ficolin-3 and the degree of coronary artery stenosis in patients with coronary heart disease and its influence on prognosis. Methods A total of 137 patients with stable coronary heart disease were classified as the coronary heart disease group. Gensini score was used to evaluate the degree of coronary artery stenosis. According to the score, patients were divided into the mild group (56 cases), the moderate group (49 cases) and the severe group (32 cases). According to the occurrence of major adverse cardiac events (MACEs) within 3 months, patients were divided into the good prognosis group (108 cases) and the poor prognosis group (29 cases). Sixty healthy subjects in the same period were selected as the control group. The clinical data of each group were collected, and serum levels of Ficolin-2 and Ficolin-3 were detected. Pearson product moment correlation analysis was used to analyze the correlation between Ficolin-2, Ficolin-3 and Gensini. Logistic regression analysis was used to analyze the influencing factors of poor prognosis. The working characteristic (ROC) curve of subjects was used to evaluate the predictive value of Ficolin-2 and Ficolin-3 for the poor prognosis. Results The serum levels of Ficolin-2 and Ficolin-3 were lower in the coronary heart disease group than those in the control group (P<0.05). The serum levels of Ficolin-2 and Ficolin-3 in the mild group, the moderate group and the severe group were decreased successively (P<0.05). The serum Ficolin-2 and Ficolin-3 levels were negatively correlated with the Gensini score in patients with coronary heart disease (r=-0.708, -0.722, P<0.05). The number of coronary artery lesions and Gensini score were independent risk factors for poor prognosis in patients with coronary heart disease [OR=1.451 (95%CI: 1.292-1.628)]. The higher levels of Ficolin-2 and Ficolin-3 were independent protective factors [OR=0.815 (95%CI: 0.730-0.909) and 0.853 (95%CI: 0.787-0.924)]. The AUC of the combination of Ficolin-2 and Ficolin-3 in predicting the poor prognosis of patients with coronary heart disease was higher than that of the single index (Z=3.186, 2.953, P<0.05). Conclusion The serum levels of Ficolin-2 and Ficolin-3 are decreased in patients with coronary heart disease, and are negatively correlated with the degree of coronary artery stenosis. The combined detection of the two indicators can predict the poor prognosis of patients with coronary heart disease, and the sensitivity is high.

Key words: coronary disease, coronary stenosis, sensitivity and specificity, fibroglutinin 2, fibroglutinin 3, major adverse cardiac events

中图分类号:

R541.4

图/表 6

参考文献 22

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组别	n	Ficolin-2	Ficolin-3
对照组	60	15.39±3.17	22.64±4.83
冠心病组	137	8.76±2.52	13.09±4.11
t		9.062^＊＊	14.219^＊＊

组别	n	Ficolin-2	Ficolin-3
对照组	60	15.39±3.17	22.64±4.83
冠心病组	137	8.76±2.52	13.09±4.11
t		9.062^＊＊	14.219^＊＊

组别	n	Ficolin-2	Ficolin-3
轻度组	56	10.25±1.98	15.61±2.78
中度组	49	8.37±2.05^a	12.59±2.34^a
重度组	32	6.80±1.53^ab	10.46±2.80^ab
F		34.832^＊＊	41.853^＊＊

组别	n	Ficolin-2	Ficolin-3
轻度组	56	10.25±1.98	15.61±2.78
中度组	49	8.37±2.05^a	12.59±2.34^a
重度组	32	6.80±1.53^ab	10.46±2.80^ab
F		34.832^＊＊	41.853^＊＊

组别	n	性别（男/女）	年龄/岁	BMI/（kg/m²）	冠心病病程/年	吸烟史	饮酒史	心血管病家族史	糖尿病史	冠状动脉单支病变
预后良好组	108	57/51	63.97±9.05	22.13±1.87	6.35±1.76	35（32.4）	46（42.6）	17（15.7）	20（18.5）	59（54.6）
预后不良组	29	18/11	62.85±8.76	22.80±1.51	6.95±1.62	10（34.5）	15（51.7）	6（20.7）	9（31.0）	3（10.3）
t或χ²		0.797	0.609	1.783	1.667	0.045	0.772	0.401	2.146	18.103^＊＊
组别	FBG/（mmol/L）	TC/（mmol/L）	TG/（mmol/L）	HDL-C/（mmol/L）	LDL-C/（mmol/L）	Ficolin-2/（mg/L）	Ficolin-3/（mg/L）
预后良好组	6.08±0.73	3.29±0.58	1.34±0.28	1.75±0.51	2.76±0.63	9.64±2.01	14.22±2.46
预后不良组	6.13±0.67	3.34±0.60	1.31±0.32	1.82±0.49	2.79±0.68	6.58±2.23	10.37±2.25
t	0.332	0.419	0.508	0.662	0.227	7.115^＊＊	7.614^＊＊