中国全科医学2024，Vol.27Issue(27)：3365-3371,7.DOI:10.12114/j.issn.1007-9572.2023.0904
急性冠脉综合征患者血清补体C1q/肿瘤坏死因子相关蛋白5水平与冠状动脉病变程度及心肌纤维化蛋白指标的相关性研究
Correlation between Serum Complement C1q/Tumor Necrosis Factor-related Protein 5 Levels and the Severity of Coronary Artery Lesions and Myocardial Fibrosis Markers in Patients with Acute Coronary Syndrome
摘要
Abstract
Background Acute coronary syndrome(ACS)represents a common cardiovascular disease that poses a significant threat to human health,with severe coronary artery lesions and myocardial fibrosis affecting patient prognosis.The use of non-invasive serological markers to assess the severity of coronary artery lesions and myocardial fibrosis can aid in the early risk stratification and management of ACS patients.Objective This study aimed to explore the relationship between serum levels of complement C1q/tumor necrosis factor-related protein-5(CTRP5)and the severity of coronary artery lesions,as well as myocardial fibrosis markers in ACS patients,to provide guidance for the clinical assessment of coronary artery lesion severity and myocardial fibrosis.Methods A total of 184 patients with obstructive stenosis admitted to the Department of Cardiology,Hengshui People's Hospital from February 2021 to February 2022 were selected,along with 100 ACS patients without significant obstructive stenosis undergoing coronary angiography in the same period as controls.General patient data were collected,Doppler echocardiograms were performed,and serum levels of CTRP5,procollagen type Ⅰ(PC Ⅰ),and procollagen type Ⅲ(PC Ⅲ)were measured.The patients with obstructive stenosis were divided into unstable angina(UA)group(n=67),ST-segment elevation myocardial infarction(STEMI)group(n=57),and non-ST-segment elevation myocardial infarction(NSTEMI)group(n=61);based on the number of coronary artery lesions,they were categorized into single-vessel disease group(n=42),double-vessel disease group(n=69),and triple-vessel disease group(n=73).According to the SYNTAX Ⅱ score,they were classified into low-risk(n=77),intermediate-risk(n=73),and high-risk(n=34)groups.Based on the median levels of PCⅠ,patients were divided into low PCⅠ level group(n=95)and high PC I level group(n=89);similarly,based on PC Ⅲ median levels,into low PC Ⅲ level group(n=93)and high PC Ⅲ level group(n=91).Multiuariate Logistic regression analysis was used to explore the influencing factors of coronary artery lesion severity.Receiver operating characteristic(ROC)curves were drawn to analyze the diagnostic value of serum CTRP5 for coronary artery lesion severity.Results In ACS patients,white blood cell count,neutrophil count,neutrophil-to-lymphocyte ratio,fasting blood glucose(FBG),high-sensitivity cardiac troponin Ⅰ,serum CTRP5,hypersensitive C-reactive protein(hs-CRP),PC Ⅰ,and PC Ⅲ levels were higher than in control patients(P<0.05).Serum CTRP5 and hs-CRP levels in the NSTEMI and STEMI groups were higher than in the UA group(P<0.05).The triple-vessel disease group had higher serum CTRP5,PC Ⅰ,PC Ⅲ,and hs-CRP levels than the single-vessel and double-vessel disease groups(P<0.05).High-risk group patients had higher serum CTRP5,PC Ⅰ,PC Ⅲ,and hs-CRP levels compared to low-risk and intermediate-risk groups(P<0.05).The high PC I level group had higher serum CTRP5 and hs-CRP levels compared to the low PC Ⅰ level group(P<0.05).The high PC Ⅲ level group had higher serum CTRP5 and hs-CRP levels compared to the low PC Ⅲ level group(P<0.05).Multivariate Logistic regression analysis showed that increased levels of FBG,hs-CRP,and CTRP5 were risk factors for multivessel coronary artery disease(P<0.05).The areas under the ROC curve(AUC)for predicting multivessel coronary artery disease by serum CTRP5,hs-CRP,and FBG were 0.736(95％CI=0.678-0.794),0.687(95％CI=0.625-0.748),and 0.649(95％CI=0.585-0.713),respectively.Conclusion Serum CTRP5 levels have good predictive value for the severity of coronary artery lesions in ACS patients,and elevated levels of CTRP5 are potentially associated with the occurrence of myocardial fibrosis.关键词
冠心病/急性冠脉综合征/心内膜心肌纤维化症/补体C1q/肿瘤坏死因子相关蛋白5Key words
Coronary disease/Acute coronary syndrome/Endomyocardial fibrosis/C1q/tumor necrosis factor-related protein-5分类
医药卫生引用本文复制引用
李勇,李占虎,靳博伟,李原,张宏博,苏亚坤,闫小菊..急性冠脉综合征患者血清补体C1q/肿瘤坏死因子相关蛋白5水平与冠状动脉病变程度及心肌纤维化蛋白指标的相关性研究[J].中国全科医学,2024,27(27):3365-3371,7.基金项目
河北省医学科学研究课题(20220456) （20220456）
