| 血清氧化三甲胺水平与冠心病及冠状动脉狭窄程度的相关性分析 |
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| 引用本文： | 邢团结,娄焕堃,李鹏,梅佳慧,王勋,韩翠敏,王怡练,孙黎明.血清氧化三甲胺水平与冠心病及冠状动脉狭窄程度的相关性分析[J].蚌埠医学院学报,2023,48(4):466-469. |
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| 作者姓名： | 邢团结 娄焕堃 李鹏 梅佳慧 王勋 韩翠敏 王怡练 孙黎明 |
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| 作者单位： | 蚌埠医学院附属连云港市第二人民医院 心血管内科, 江苏 连云港 222006 |
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| 基金项目： | 江苏省“六大人才高峰”资助项目2015-WSN-098江苏省连云港市科技局社会发展项目SH1537 |
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| 摘 要： | 目的：探讨血清氧化三甲胺(TMAO)水平与冠心病(CHD)及冠状动脉狭窄程度的相关性。方法：选取行冠状动脉造影(CAG)诊治的病人390例，其中CHD组285例，包括急性冠状动脉综合征(ACS)组173例、慢性冠状动脉综合征(CCS)组112例；经CAG排除CHD的病人105例为对照组。其中ACS病人分为ST段抬高型心肌梗死(STEMI)组、非ST段抬高型心肌梗死(NSTEMI)组、不稳定性心绞痛(UAP)组三个亚组；按照Gensini评分标准将CHD病人分为轻度狭窄组、中度狭窄组、重度狭窄组。采用酶联免疫吸附试验(ELISA)测定血清TMAO水平，比较各组一般资料及血清TMAO水平。结果：3组年龄、性别、身高、体质量、体质量指数、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肌酐、尿素氮、血糖、糖尿病史比较差异均无统计学意义(P>0.05)。与对照组比较，ACS组和CCS组病人患高血压比例、吸烟比例、脂蛋白磷脂酶A2(Lp-PLA2)、脑钠肽(BNP)、TMAO水平明显升高(P<0.01),且ACS组病人总胆固醇(TC)、白细胞介素...
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| 关 键 词： | 冠心病 氧化三甲胺 动脉粥样硬化 冠状动脉综合征 |
| 收稿时间： | 2022-05-14 |
Correlation analysis of serum trimethylamine N-oxide level and coronary heart disease and the degree of coronary artery stenosis |
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| Affiliation: | Department of Cardiovascular Medicine, Lianyungang Second People's Hospital Affiliated to Bengbu Medical College, Lianyungang Jiangsu 222006, China |
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| Abstract: | ObjectiveTo investigate the correlation of serum trimethylamine N-oxide (TMAO) level and coronary heart disease (CHD) and the degree of coronary artery stenosis.MethodsA total of 390 patients who underwent coronary angiography (CAG) were selected, including 285 cases in the CHD group, 173 cases in the acute coronary syndrome (ACS) group and 112 cases in the chronic coronary syndrome (CCS) group.Another 105 patients with CHD excluded by CAG were included in the control group.ACS patients was divided into three subgroups: ST-segment elevation myocardial infarction (STEMI) group, non-ST-segment elevation myocardial infarction (NSTEMI) group and unstable angina pectoris (UAP) group.According to Gensini scoring criteria, CHD patients were divided into mild stenosis group, moderate stenosis group and severe stenosis group.Serum TMAO level was measured by enzyme-linked immunosorbent assay (ELISA), and the general information and serum TMAO level were compared among the groups.ResultsThere were no significant differences in age, gender, height, weight, body mass index, triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), creatinine, urea nitrogen, blood glucose and history of diabetes mellitus among the three groups (P>0.05).Compared with the control group, the proportion of hypertension, the proportion of smoking, the levels of LP-PLA2, BNP and TMAO in the ACS group and CCS group were significantly increased (P < 0.01), and the levels of TC, IL-6 and hs-CRP in the ACS group were significantly higher than those in the control group (P < 0.05 to P < 0.01).Compared with the CCS group, the levels of TC, IL-6, hs-CRP, LP-PLA2 and TMAO in the ACS group were significantly higher (P < 0.01).There was no significant difference in serum TMAO level among the three groups (P>0.05).Logistic regression analysis showed that TMAO, TC, LP-PLA2, smoking and hypertension were independent risk factors for CHD (P < 0.05 to P < 0.01).ROC curve analysis showed that the optimal cut-off value of serum TMAO for diagnosing CHD was 13.80 μmol/L, AUC was 0.702, sensitivity and specificity were 73.70% and 62.90%, respectively.The AUC of TMAO+IL-6+ LP-PLA2 +hs-CRP was 0.792, and the sensitivity and specificity were 71.60% and 74.30%, respectively.The levels of TMAO in the moderate and severe stenosis groups were significantly higher than those in the mild group, and those in the severe group were significantly higher than those in the moderate group (P < 0.01).ConclusionsThe level of serum TMAO in patients with CHD is higher, and the level in patients with ACS is higher than that in patients with CCS, which is an independent risk factor for CHD and can be used as a potential index for the diagnosis and evaluation of the degree of coronary artery stenosis in CHD. |
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