血浆中性粒细胞明胶酶相关脂质运载蛋白与冠心病严重程度的相关性#br#

摘要：目的　探讨血浆中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平与不同类型冠心病（CHD）患者冠状动脉狭窄严重程度的关系。方法　回顾性分析2017年12月—2019年12月在我院治疗的180例冠心病患者，按照临床表现及实验室检查分为ST段抬高型心肌梗死（STEMI）组61例、稳定型心绞痛（SAP）组58例和对照组61例。所有患者均接受标准冠状动脉血管造影（CAG）检查，采用SYNTAX评分评估冠状动脉病变严重程度。CAG检查前采集外周静脉血5 mL，分离血浆后采用酶联免疫吸附测定（ELISA）法检测NGAL、基质金属蛋白酶-9（MMP-9）、同型半胱氨酸（Hcy）、高敏C反应蛋白（hs-CRP）水平。采用受试者工作特征（ROC）曲线评估血浆NGAL、MMP-9、Hcy和hs-CRP对高SYNTAX评分（＞33分）的预测价值。结果　STEMI组患者总胆固醇、低密度脂蛋白胆固醇、白细胞计数、MMP-9、hs-CRP和NGAL显著高于SAP组和对照组，SYNTAX评分高于SAP组，而LVEF显著低于SAP组和对照组（均P＜0.05）。NGAL预测高SYNTAX评分的曲线下面积为0.890（95%CI：0.815~0.964），优于MMP-9（0.851，95%CI：0.775~0.927）、Hcy（0.554，95%CI：0.380~0.727）和hs-CRP（0.680，95%CI：0.523~0.838）。相关性分析示SYNTAX评分与NGAL、MMP-9、hs-CRP存在正相关（rs分别为0.426、0.434、0.184，P＜0.05），与Hcy无显著相关性（rs=0.096，P=0.647）。结论　NGAL对冠心病患者冠状动脉狭窄严重程度的预测价值优于MMP-9、Hcy、hs-CRP，将有助于冠心病患者的危险分层。

Correlation between plasma neutrophil gelatinase-associated lipocalin andseverity of coronary heart disease#br#

Abstract: Objective　To investigate the correlation between plasma neutrophil gelatinase-associated lipoprotein (NGAL) and the severity of coronary stenosis in patients with different types of coronary heart disease (CHD). Methods　 Data of 180 patients with coronary heart disease treated in our hospital from December 2017 to December 2019 were retrospectively analyzed. Patients were divided into ST-segment elevation myocardial infarction group (STEMI, n=61), stable type angina pectoris group (SAP, n=58) and control group (n=61) according to clinical manifestations and laboratory examinations. All patients underwent standard coronary angiography (CAG) examination. The SYNTAX score was used to assess the severity of coronary artery disease. Before CAG examination, 5 mL of peripheral venous blood was collected. After plasma was separated, the levels of NGAL, matrix metalloproteinase-9 (MMP-9), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) were detected by enzyme-linked immunosorbent assay (ELISA). The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of plasma NGAL, MMP-9, Hcy and hs-CRP for high SYNTAX score (＞33 points). Results　Levels of total cholesterol, low-density lipoprotein, white blood cells, MMP-9, hs-CRP and NGAL were significantly higher in STEMI group than those of SAP group and control group. The score of SYNTAX was significantly higher in STEMI group than that of SAP group. The LVEF was significantly lower in STEMI group than that of SAP group and control group (P＜0.05). The area under the curve predicted by NGAL for high SYNTAX scores was 0.890 (95%CI: 0.815-0.964), which was better than MMP-9 (0.851, 95%CI: 0.775-0.927), Hcy (0.554, 95%CI: 0.380-0.727) andhs-CRP (0.680, 95%CI: 0.523-0.838). Correlation analysis showed that SYNTAX score was positively correlated with NGAL (rs=0.426), MMP-9 (rs=0.434), hs-CRP (rs=0.184, all P＜0.05), and which was no significant correlation with Hcy (rs=0.096, P=0.647). Conclusion　NGAL is superior to MMP-9, Hcy and hs-CRP in predicting the severity of coronary stenosis in patients with coronary heart disease. NGAL as a new biomarker will help the risk stratification of patients with coronary heart disease.