应用冠状动脉造影分析γ谷氨酰转移酶与冠心病的相关性

目的探讨血浆γ谷氨酰转移酶(γ-GT)水平与冠心病的相关关系。方法选择行冠状动脉造影术的425例患者为研究对象,其中正常组196例、急性心肌梗死组65例、不稳定型心绞痛组84例和稳定型心绞痛组80例。所有患者测定血浆γ-GT水平;根据造影结果采用Gensini评分系统对冠心病组每支血管病变程度进行定量评定,行记录住院期间心血管事件(MACE)的发生。应用卡方检验、方差分析及t检验比较各项临床资料的差异,Pearson积距相关分析γ-GT与冠状动脉病变严重程度的相关性。并采用Logistic回归模型方法分析MACE的危险因素,应用受试者工作曲线(ROC)分析其最佳切入值。结果与对照组相比,冠心病组血浆γ-GT水平显著升高[(27.2±16.1)U/L比(19.5±12.1)U/L,P=0.003]。相关分析显示血浆γ-GT水平与冠状动脉病变严重程度呈正相关(r=0.343,P=0.01)。Logistic回归分析表明血浆γ-GT水平是心血管事件发生的危险因素(OR=1.202,P<0.001),切入值为33 U/L。结论血浆γ-GT与冠状动脉病变严重程度相关,是心血管事件发生的危险因素。

The correlation between serum gamma-glutamyltransferase and coronary heart disease

Objective To study the correlation between serum gamma-glutamyltransferase （γ-GT） and coronary heart disease （ CHD ） . Methods The study population included 425 patients who received coronary angiography. According to the results of coronary angiogram, patients were divided into two groups, CHD group （ n = 229 ） and control group （n = 196）. Furthermore, the CHD group was divided into acute myocardial infarction （AMI） group （ n = 65 ）, unstable angina peetoris （UAP） group （n = 84 ） and stable angina peetoris （SAP） group （n = 80）. The levels of serum γ-GT were measured and the Gensini scoring system was used to determine the results of the coronary angiography. The major adverse cardiac events （MACE） were collected during hospitalization. All parameters were compared among different groups to investigate the relationship between serum γ-GT levels and the degree of coronary artery lesions. The predictive factors of MACE were determined using Logistic regression analysis. The receiver operating characteristics analysis （ROC） was used to determin the cut-off points of γ-GT. Results The serum γ-GT levels in CHD group were significantly higher than that in control group [（27.21 ± 16.12） U/L vs. （19.5 ±12.1） U/L,P =0.003 %]. The serum γ-GT was correlated with the degree of coronary artery lesions （ r = 0. 343, P = 0. 01 ） , and was proved to be a predictive factor of MACE in patients with CHD by means of Logistic regression analysis （ OR = 1. 202,P 〈0. 001 ）. The cut-off point was 33 U/L. Conclusions The serum γ-GT level is correlated with the degree of coronary artery lesions, and it is a predictive factor of MACE in CHD patients. Serum γ-GT may play a role in the pathogenesis of the atherosclerosis.