心外膜脂肪厚度联合血清ADAM10、STIM1对冠心病的诊断价值

doi:10.11958/20250781

天津医药 ›› 2025, Vol. 53 ›› Issue (9): 963-966.doi: 10.11958/20250781

心外膜脂肪厚度联合血清ADAM10、STIM1对冠心病的诊断价值

徐培璐¹(), 乔建民¹, 李静², 刘建荣³, 陈树军¹, 季春鹏⁴

1 开滦总医院放射科（邮编063000）
2 唐山市妇幼保健院放射科
3 乐亭县医院MR室
4 开滦总医院心内科

收稿日期:2025-03-12 修回日期:2025-06-12 出版日期:2025-09-15 发布日期:2025-09-16
作者简介:徐培璐（1985），男，主治医师，主要从事CT能谱成像对急性缺血性脑卒中诊断方面研究。E-mail：xucx5mo@163.com
基金资助:
河北省卫生健康委科研基金项目(20221580)

Diagnostic value of epicardial adipose tissue thickness combined with serum ADAM10 and STIM1 for coronary heart disease

XU Peilu¹(), QIAO Jianmin¹, LI Jing², LIU Jianrong³, CHEN Shujun¹, JI Chunpeng⁴

1 Department of Radiology, Kailuan General Hospital, Tangshan 063000, China
2 Department of Radiology, Tangshan Maternal and Child Health Hospital
3 MR Room, Laoting County Hospital
4 Department of Cardiology, Kailuan General Hospital

Received:2025-03-12 Revised:2025-06-12 Published:2025-09-15 Online:2025-09-16

徐培璐, 乔建民, 李静, 刘建荣, 陈树军, 季春鹏. 心外膜脂肪厚度联合血清ADAM10、STIM1对冠心病的诊断价值[J]. 天津医药, 2025, 53(9): 963-966.

XU Peilu, QIAO Jianmin, LI Jing, LIU Jianrong, CHEN Shujun, JI Chunpeng. Diagnostic value of epicardial adipose tissue thickness combined with serum ADAM10 and STIM1 for coronary heart disease[J]. Tianjin Medical Journal, 2025, 53(9): 963-966.

摘要/Abstract

摘要：

目的探讨心外膜脂肪（EAT）厚度联合血清解整合素金属蛋白酶10（ADAM10）、基质交联分子1（STIM1）对冠心病（CHD）的诊断价值。方法纳入119例CHD患者为研究组，另择同期非CHD患者100例为对照组。收集患者临床资料，采用酶联免疫吸附试验（ELISA）测定血清ADAM10、STIM1水平，应用彩色多普勒超声诊断仪检测EAT厚度；采用多因素Logistic回归分析CHD发生的影响因素，受试者工作特征（ROC）曲线分析EAT厚度联合血清ADAM10、STIM1水平对CHD的诊断价值。结果研究组的三酰甘油、低密度脂蛋白胆固醇（LDL-C）、EAT厚度、血清ADAM10和STIM1水平均高于对照组（P<0.05）。Logistic回归分析显示，EAT厚度、血清ADAM10、STIM1、三酰甘油、LDL-C水平升高为CHD发生的独立危险因素（P<0.05）。ROC曲线分析显示，EAT厚度联合血清ADAM10、STIM1诊断CHD的曲线下面积[0.864（95%CI：0.811~0.907）]高于各自单独诊断[分别为0.801（95%CI：0.741~0.851）、0.750（95%CI：0.687~0.806）、0.799（95%CI：0.740~0.850）]，联合诊断的敏感度和特异度分别为82.35%和83.00%。结论 CHD患者EAT厚度及血清ADAM10、STIM1水平明显升高，三者联合检测对CHD具有较高的诊断价值。

关键词: 冠心病, 心外膜脂肪厚度, 解整合素金属蛋白酶10, 基质交联分子1

Abstract:

Objective To explore the diagnostic value of epicardial adipose tissue (EAT) thickness combined with serum disintegrin metalloprotease 10 (ADAM10) and stromal interaction molecule 1 (STIM1) in coronary heart disease (CHD). Methods A total of 119 CHD patients were included as the study group, and 100 non-CHD patients in the same period were selected as the control group. The clinical data of the patients were collected. Serum ADAM10 and STIM1 levels were detected by enzyme-linked immunosorbent assay (ELISA). Color Doppler ultrasonography was applied to detect EAT thickness. Multivariate Logistic regression was used to analyze influencing factors of CHD occurrence. The diagnostic value of EAT thickness combined with serum ADAM10 and STIM1 levels in the diagnosis of CHD was analyzed by subject work characteristics (ROC) curves. Results The levels of triglycerides, low-density lipoprotein cholesterol (LDL-C), EAT thickness, serum ADAM10 and STIM1 were higher in the study group than those in the control group (P<0.05). Logistic regression analysis showed that elevated EAT thickness, serum ADAM10, STIM1, triglyceride and LDL-C levels were independent risk factors for the occurrence of CHD (P<0.05). ROC curve analysis showed that the area under the curve of EAT thickness combined with serum ADAM10 and STIM1 for the diagnosis of CHD [0.864 (95%CI: 0.811-0.907)] was higher than that of their respective individual diagnoses [0.801 (95%CI: 0.741-0.851), 0.750 (95%CI: 0.687-0.806), respectively, 0.799 (95%CI: 0.740-0.850)], and the sensitivity and specificity of the combined diagnosis were 82.35% and 83.00%, respectively. Conclusion EAT thickness, serum ADAM10 and STIM1 levels are obviously elevated in CHD patients, and the combination of the three tests has a high diagnostic value for CHD.

Key words: coronary disease, epicardial adipose tissue thickness, a disintegrin and metalloprotease 10, stromal interaction molecule 1

中图分类号:

R542.2

图/表 5

参考文献 22

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组别	n		年龄/ 岁		性别（男/女）		BMI/ （kg/m²）	高血压		糖尿病		吸烟史		酗酒史		TG/（mmol/L）		TC/（mmol/L）
对照组	100		58.67±6.11		53/47		22.65±2.36	67（67.00）		35（35.00）		31（31.00）		43（43.00）		1.52±0.17		4.58±0.95
研究组	119		59.78±6.15		64/55		22.59±2.37	75（63.03）		46（38.66）		39（32.77）		52（43.70）		2.29±0.25		4.67±1.09
t或χ²			1.336		0.013		0.187	0.377		0.312		0.079		0.011		25.254^＊		0.641
组别		LDL-C/ （mmol/L）		HDL-C/ （mmol/L）		收缩压/ mmHg			舒张压/ mmHg		CRP/ （mg/L）		血Cr/（μmol/L）		Fib/ （g/L）		UA/ （μmol/L）
对照组		2.75±0.32		1.15±0.26		136.58±16.35			83.95±9.68		22.85±3.93		65.45±17.33		3.19±0.61		351.96±65.27
研究组		3.55±0.73		1.12±0.23		135.47±15.85			81.71±9.37		23.16±4.01		68.54±16.62		3.15±0.55		358.65±65.33
t或χ²		10.746^＊		0.656		0.509			1.733		0.575		1.344		0.507		0.754

组别	n		年龄/ 岁		性别（男/女）		BMI/ （kg/m²）	高血压		糖尿病		吸烟史		酗酒史		TG/（mmol/L）		TC/（mmol/L）
对照组	100		58.67±6.11		53/47		22.65±2.36	67（67.00）		35（35.00）		31（31.00）		43（43.00）		1.52±0.17		4.58±0.95
研究组	119		59.78±6.15		64/55		22.59±2.37	75（63.03）		46（38.66）		39（32.77）		52（43.70）		2.29±0.25		4.67±1.09
t或χ²			1.336		0.013		0.187	0.377		0.312		0.079		0.011		25.254^＊		0.641
组别		LDL-C/ （mmol/L）		HDL-C/ （mmol/L）		收缩压/ mmHg			舒张压/ mmHg		CRP/ （mg/L）		血Cr/（μmol/L）		Fib/ （g/L）		UA/ （μmol/L）
对照组		2.75±0.32		1.15±0.26		136.58±16.35			83.95±9.68		22.85±3.93		65.45±17.33		3.19±0.61		351.96±65.27
研究组		3.55±0.73		1.12±0.23		135.47±15.85			81.71±9.37		23.16±4.01		68.54±16.62		3.15±0.55		358.65±65.33
t或χ²		10.746^＊		0.656		0.509			1.733		0.575		1.344		0.507		0.754

组别	n	EAT厚度/mm	ADAM10/（ng/L）	STIM1/（ng/L）
对照组	100	5.67±0.93	1 893.42±398.47	37.52±7.85
研究组	119	6.84±1.25	2 327.60±465.73	46.14±8.91
t		7.963^＊	7.335^＊	7.530^＊

组别	n	EAT厚度/mm	ADAM10/（ng/L）	STIM1/（ng/L）
对照组	100	5.67±0.93	1 893.42±398.47	37.52±7.85
研究组	119	6.84±1.25	2 327.60±465.73	46.14±8.91
t		7.963^＊	7.335^＊	7.530^＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
EAT厚度	0.618	0.239	6.695	0.010	1.856	1.162~2.965
ADAM10	0.493	0.213	5.354	0.021	1.637	1.078~2.485
STIM1	0.763	0.315	5.869	0.015	2.145	1.157~3.978
TG	0.707	0.285	6.146	0.013	2.027	1.159~3.544
LDL-C	0.498	0.216	5.310	0.021	1.645	1.077~2.512
常数项	-23.854	2.762	58.213	<0.001	0.000

心外膜脂肪厚度联合血清ADAM10、STIM1对冠心病的诊断价值

Diagnostic value of epicardial adipose tissue thickness combined with serum ADAM10 and STIM1 for coronary heart disease

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变量	AUC	95%CI	截断值	敏感度/ %	特异度/ %	约登指数
EAT厚度	0.801	0.741~0.851	6.50 mm	57.98	89.00	0.520
ADAM10	0.750	0.687~0.806	2 174.62 ng/L	64.71	78.00	0.427
STIM1	0.799	0.740~0.850	40.68 ng/L	75.63	71.00	0.466
三者联合	0.864	0.811~0.907	-	82.35	83.00	0.654

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