NO、ET-1、Hcy联合检测在冠心病中的诊断价值
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摘要
目的探讨内皮功能指标血清一氧化氮(NO)、内皮素-1(ET-1)、同型半胱氨酸(Hcy)联合检测在冠心病中的诊断价值。方法选取2017年3—9月开化县人民医院就诊的232例冠心病患者为观察组,另选取128例健康者为对照组。比较2组受试者的NO、ET-1、Hcy水平,采用受试者工作特征曲线(ROC)下面积(AUC)比较NO、ET-1、Hcy以及联合检测对冠心病的诊断价值,采用单因素分析和logistic回归分析法分析影响冠心病的危险因素。结果观察组的NO水平明显低于对照组,而观察组ET-1、Hcy水平明显高于对照组(均P<0.05);联合检测的AUC值明显高于NO、ET-1、Hcy单独检测的AUC值(均P<0.05);观察组的高血压、糖尿病、血脂异常、吸烟、肥胖发生率明显高于对照组(均P<0.05);以是否为冠心病为因变量,将高血压、糖尿病、血脂异常、吸烟、肥胖以及ET-1、Hcy、NO作为自变量,进行多因素logistic回归分析,结果显示,除高血压、血脂异常、吸烟、肥胖因素外,ET-1、Hcy、NO也可作为评估冠心病的危险因素(均P<0.05),且冠心病的关联强度由高到低依次为ET-1、Hcy、NO。结论 NO、ET-1、Hcy联合检测能够有效诊断冠心病的发生,且可作为冠心病发作风险的有效指标。
Objective To investigate the diagnostic value of nitric oxide(NO), endothelin-1(ET-1) and homocysteine(Hcy) combined detection in coronary heart disease. Methods A total of 232 coronary heart disease patients as observation group were selected from March 2017 to September 2017 in our hospital, and 128 healthy subjects as control group. The levels of NO, ET-1 and Hcy in the two groups were compared. The detection value of NO, ET-1, Hcy and combined detection of NO, ET-1 and Hcy to coronary heart disease were compared by using the area(AUC) under the receiver operator characteristics curve(ROC). The univariate analysis and logistic regression analysis were used to analyzed risk factors affecting coronary heart disease. Results The level of NO in the observation group was significantly lower than that in the control group, but the level of ET-1 and Hcy in the observation group was significantly higher than those in the control group(all P<0.05). The AUC value of combined detection is significantly higher than the AUC value of NO, ET-1 and Hcy alone(all P<0.05). The incidence of hypertension, diabetes, dyslipidemia, smoking and obesity in the observation group was significantly higher than that in the control group(all P<0.05). Whether as the coronary heart disease as dependent variable, the high blood pressure, diabetes, dyslipidemia, smoking, obesity and ET-1, Hcy, NO as independent variables, multivariable logistic regression analysis, the results showed that the factors in addition to hypertension, dyslipidemia, smoking, obesity, ET-1, Hcy, NO also could be used as evaluating a risk factor for coronary heart disease(all P<0.05), and the correlation strength with coronary heart disease from high to low is ET-1, Hcy, NO. Conclusion The combined detection of NO, ET-1 and Hcy can effectively diagnose the occurrence of coronary heart disease, and it can be used as an effective indicator of the risk of coronary heart disease attack.
Objective To investigate the diagnostic value of nitric oxide(NO), endothelin-1(ET-1) and homocysteine(Hcy) combined detection in coronary heart disease. Methods A total of 232 coronary heart disease patients as observation group were selected from March 2017 to September 2017 in our hospital, and 128 healthy subjects as control group. The levels of NO, ET-1 and Hcy in the two groups were compared. The detection value of NO, ET-1, Hcy and combined detection of NO, ET-1 and Hcy to coronary heart disease were compared by using the area(AUC) under the receiver operator characteristics curve(ROC). The univariate analysis and logistic regression analysis were used to analyzed risk factors affecting coronary heart disease. Results The level of NO in the observation group was significantly lower than that in the control group, but the level of ET-1 and Hcy in the observation group was significantly higher than those in the control group(all P<0.05). The AUC value of combined detection is significantly higher than the AUC value of NO, ET-1 and Hcy alone(all P<0.05). The incidence of hypertension, diabetes, dyslipidemia, smoking and obesity in the observation group was significantly higher than that in the control group(all P<0.05). Whether as the coronary heart disease as dependent variable, the high blood pressure, diabetes, dyslipidemia, smoking, obesity and ET-1, Hcy, NO as independent variables, multivariable logistic regression analysis, the results showed that the factors in addition to hypertension, dyslipidemia, smoking, obesity, ET-1, Hcy, NO also could be used as evaluating a risk factor for coronary heart disease(all P<0.05), and the correlation strength with coronary heart disease from high to low is ET-1, Hcy, NO. Conclusion The combined detection of NO, ET-1 and Hcy can effectively diagnose the occurrence of coronary heart disease, and it can be used as an effective indicator of the risk of coronary heart disease attack.
引文
[1] 国家卫生计生委合理用药专家委员会,中国药师协会.冠心病合理用药指南[J].中国医学前沿杂志:电子版,2016,8(6):19-108.
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[3] 何继强,陈方.冠状动脉CT造影的无创血流储备分数(FFRCT)在冠心病诊治中的研究进展[J].心肺血管病杂志,2015,34(3):232-235.
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[7] 孙佳艺,赵冬,刘静,等.中国缺血性脑卒中住院患者颈动脉粥样硬化病变性别差异的分析[J].心肺血管病杂志,2016,35(2):81-86.
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[9] 李峰杰,李贻奎.心血管疾病中硫化氢/胱硫醚γ裂解酶系统与一氧化氮/一氧化氮合酶系统的相互作用研究进展[J].中国药业,2016,25(15):1-4.
[10] 刘宁,刘昊,王志军,等.脑钠肽与内皮素-1对心力衰竭患者心血管事件的预测价值[J].中国医学前沿杂志(电子版),2016,8(1):55-58.
[11] 孔繁亮,陈小艳,吴同果.广州人血同型半胱氨酸与心血管疾病的相关性分析[J].岭南心血管病杂志,2016,22(2):192-195.
[12] 赵伟,李婷婷,李莹.冠心病患者炎性因子水平与急性冠状动脉综合征的相关性分析[J].中华老年心脑血管病杂志,2014,16(2):207-208.
[13] 田华,王素琴,李雪梅.冠心病的研究进展[J].世界最新医学信息文摘,2016,16(76):52-53.
[14] 符裕.血脂异常与冠心病研究进展[J].中西医结合心血管病电子杂志,2014,2(2):143-144.
[15] 彭丽.血小板参数在冠心病中的研究进展[J].检验医学与临床,2017,14(Z1):384-386.
[16] 石衍梅,李洁,蔚若川,等.冠心病发病机制研究进展[J].中国冶金工业医学杂志,2016,33(2):137-138.
[17] 周春亭,王朝晖.吸入外源性一氧化氮对急性缺血性卒中患者血管内皮细胞功能、血小板功能及血栓形成的影响[J].实用心脑肺血管病杂志,2016,24(2):63-65.
[18] 谢月娜.一氧化氮抑制血小板保存损伤的研究进展[J].继续医学教育,2017,31(8):91-93.
[19] 肖丹丹,诸葛欣,陶珍珍.同型半胱氨酸导致血管内皮细胞损伤机制的研究进展[J].中华临床医师杂志:电子版,2016,10(18):2789-2793.
[20] 周奎臣,刘丽秋,崔国利,等.小而密低密度脂蛋白胆固醇与同型半胱氨酸在脑血管疾病中的应用[J].黑龙江医药科学,2017,40(4):18-19.
[21] 李楠,刘迎娣,郭明洲,等.外源性脂联素对内皮素1诱导的肝星状细胞收缩的影响及作用机制[J].临床肝胆病杂志,2016,32(2):307-311.
[22] 李小红,郭凤霞,杨沁,等.自噬干预对低剪切应力下血管内皮细胞eNOS和ET-1表达的影响[J].中国动脉硬化杂志,2014,22(9):875-880.
[2] 任中钧,孙天福,袁智宇.中医对冠心病的认识和研究进展[J].中医临床研究,2015,7(8):147-148.
[3] 何继强,陈方.冠状动脉CT造影的无创血流储备分数(FFRCT)在冠心病诊治中的研究进展[J].心肺血管病杂志,2015,34(3):232-235.
[4] 徐彧,赵天佐.冠心病影像学诊断研究进展[J].中国中西医结合影像学杂志,2016,14(5):608-610.
[5] 马国强.冠心病的超声诊断现状及研究进展[J].中国处方药,2017,15(12):20-21.
[6] 曹裕民,张雄,万鑫,等.性别与症状性颅内动脉粥样硬化性狭窄关系的研究[J].中华老年心脑血管病杂志,2014,16(1):62-65.
[7] 孙佳艺,赵冬,刘静,等.中国缺血性脑卒中住院患者颈动脉粥样硬化病变性别差异的分析[J].心肺血管病杂志,2016,35(2):81-86.
[8] 谢辉.心血管病危险因素与颈动脉粥样硬化预后之间的关系[J].中国卫生产业,2014,12(16):480-481.
[9] 李峰杰,李贻奎.心血管疾病中硫化氢/胱硫醚γ裂解酶系统与一氧化氮/一氧化氮合酶系统的相互作用研究进展[J].中国药业,2016,25(15):1-4.
[10] 刘宁,刘昊,王志军,等.脑钠肽与内皮素-1对心力衰竭患者心血管事件的预测价值[J].中国医学前沿杂志(电子版),2016,8(1):55-58.
[11] 孔繁亮,陈小艳,吴同果.广州人血同型半胱氨酸与心血管疾病的相关性分析[J].岭南心血管病杂志,2016,22(2):192-195.
[12] 赵伟,李婷婷,李莹.冠心病患者炎性因子水平与急性冠状动脉综合征的相关性分析[J].中华老年心脑血管病杂志,2014,16(2):207-208.
[13] 田华,王素琴,李雪梅.冠心病的研究进展[J].世界最新医学信息文摘,2016,16(76):52-53.
[14] 符裕.血脂异常与冠心病研究进展[J].中西医结合心血管病电子杂志,2014,2(2):143-144.
[15] 彭丽.血小板参数在冠心病中的研究进展[J].检验医学与临床,2017,14(Z1):384-386.
[16] 石衍梅,李洁,蔚若川,等.冠心病发病机制研究进展[J].中国冶金工业医学杂志,2016,33(2):137-138.
[17] 周春亭,王朝晖.吸入外源性一氧化氮对急性缺血性卒中患者血管内皮细胞功能、血小板功能及血栓形成的影响[J].实用心脑肺血管病杂志,2016,24(2):63-65.
[18] 谢月娜.一氧化氮抑制血小板保存损伤的研究进展[J].继续医学教育,2017,31(8):91-93.
[19] 肖丹丹,诸葛欣,陶珍珍.同型半胱氨酸导致血管内皮细胞损伤机制的研究进展[J].中华临床医师杂志:电子版,2016,10(18):2789-2793.
[20] 周奎臣,刘丽秋,崔国利,等.小而密低密度脂蛋白胆固醇与同型半胱氨酸在脑血管疾病中的应用[J].黑龙江医药科学,2017,40(4):18-19.
[21] 李楠,刘迎娣,郭明洲,等.外源性脂联素对内皮素1诱导的肝星状细胞收缩的影响及作用机制[J].临床肝胆病杂志,2016,32(2):307-311.
[22] 李小红,郭凤霞,杨沁,等.自噬干预对低剪切应力下血管内皮细胞eNOS和ET-1表达的影响[J].中国动脉硬化杂志,2014,22(9):875-880.