血清DPP4、PCT与急性冠脉综合征患者冠状动脉病变程度及新发心血管事件关系探讨
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摘要
目的探讨血清二肽基肽酶4(DPP4)、降钙素原(PCT)与急性冠脉综合征患者冠状动脉病变狭窄程度及对后期新发心血管事件的关系。方法选择2014年6月-2015年6月期间在我院行冠状动脉造影确诊为急性冠脉综合征患者180例患者作为研究对象,检测患者血清DPP4及PCT水平,探讨其与冠状动脉病变的关系,并对所有患者均定期进行随访,记录患者心血管事件发生情况,探讨血清学指标对患者新发心血管事件的预测价值。结果多支病变患者DPP4和PCT水平明显高于双支病变和单支病变;TIMI 0级患者DPP4和PCT水平分明显高于TIMIⅠ级、Ⅱ级、Ⅲ级(P<0.05)。血清DPP4、PCT与冠脉病变支数和狭窄程度均成正相关(P<0.05)。血清DPP4≥9.58ng/L、TIMI等级≤Ⅰ级、冠脉病变支数≥2支是患者心血管事件的独立风险因素。结论冠脉病变支数及冠脉狭窄程度均与DPP4、PCT均成正相关,DPP4是急性冠脉综合征患者心血管事件的独立风险因素。
Objective To investigate the relationship between serum dipeptidyl peptidase 4(DPP4),procalcitonin(PCT)and coronary artery disease in patients with coronary heart disease and their predictive value of new cardiovascular events.Methods 80 cases diagnosed with coronary heart disease in our hospital from Jun 2014 to Jun 2015 were selected,and the serum level of DPP4 and PCT were measured and their relationship with coronary artery disease was investigated.All patients were followed up regularly to record the occurrence of cardiovascular events,and to explore the predictive value of DPP4 and PCT on new cardiovascular events.Results Serum DPP4 and PCT in patients with multivessel disease were significantly higher than those in double-vessel or multi-vessel cases(P<0.05).The levels of DPP4 and PCT in patients with complete occlusion were significantly higher than those in mild,moderate or severe stenosis(P<0.05).Serum DPP4 and PCT were positively correlated with the number of coronary lesions and degree of stenosis(P<0.05).Serum DPP4>9.58 ng/L,coronary stenosis>75%,and coronary artery lesions≥2 were independent risk factors for cardiovascular events.Conclusion The number of coronary lesions and degree of coronary stenosis were positively correlated with DPP4 and PCT.DPP4 was an independent risk factor for cardiovascular events in patients with coronary heart disease.
Objective To investigate the relationship between serum dipeptidyl peptidase 4(DPP4),procalcitonin(PCT)and coronary artery disease in patients with coronary heart disease and their predictive value of new cardiovascular events.Methods 80 cases diagnosed with coronary heart disease in our hospital from Jun 2014 to Jun 2015 were selected,and the serum level of DPP4 and PCT were measured and their relationship with coronary artery disease was investigated.All patients were followed up regularly to record the occurrence of cardiovascular events,and to explore the predictive value of DPP4 and PCT on new cardiovascular events.Results Serum DPP4 and PCT in patients with multivessel disease were significantly higher than those in double-vessel or multi-vessel cases(P<0.05).The levels of DPP4 and PCT in patients with complete occlusion were significantly higher than those in mild,moderate or severe stenosis(P<0.05).Serum DPP4 and PCT were positively correlated with the number of coronary lesions and degree of stenosis(P<0.05).Serum DPP4>9.58 ng/L,coronary stenosis>75%,and coronary artery lesions≥2 were independent risk factors for cardiovascular events.Conclusion The number of coronary lesions and degree of coronary stenosis were positively correlated with DPP4 and PCT.DPP4 was an independent risk factor for cardiovascular events in patients with coronary heart disease.
引文
[1]孙菁,曾强,董剩勇,等.急性冠脉综合征患者冠脉病变与临床预后的关系[J].中国循证心血管医学杂志,2013,5(6):618.
[2]周梦阳.冠心病患者血清DPP4水平与冠脉病变的关系[D].河北医科大学,2015.
[3]Dai J,Xia B,Wu X.Elevated plasma procalcitonin level predicts poor prognosis of ST elevation myocardial infarction in Asian elderly[J].Scand J Clin Lab Invest,2018,78(1-2):49.
[4]Antman EM,Hand M,Armstrong PW,et al.2007focused update of the ACC/AHA 2004guidelines for the management of patients with ST-elevation myocardial infarction:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2008,51(2):210.
[5]Collet C,Grundeken MJ,Asano T,et al.State of the art:coronary angiography[J].EuroIntervention,2017,13(6):634.
[6]王艺霏,王勇,韩超,等.冠心病患者血清IL-1ra和IL-6水平与冠脉病变程度及预后的相关性研究[J].海南医学,2014,25(20):3017.
[7]仲艳华,罗立波,蒋敬庭,等.冠心病患者血清白介素-17与血管假友病因子、C-反应蛋白水平及冠脉病变程度的相关性[J].中国医药导报,2013,10(17):40.
[8]Liou K,Jepson N,Buckley N,et al.Design and Rationale for the Endothelin-1Receptor Antagonism in the Prevention of Microvascular Injury in Patients with non-ST Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention(EN-DORA-PCI)Trial[J].Cardiovasc Drugs Ther,2016,30(2):169.
[9]杨文英.DPP-4抑制剂维格列汀的心血管效应[J].药品评价,2014,11(9):23.
[10]张雪松,秦明照.GLP-1受体激动剂和DPP-4抑制剂对心血管系统的保护作用[J].临床药物治疗杂志,2013,11(4):42.
[11]Giannakopoulos K,Hoffmann U,Ansari U,et al.The Use of Biomarkers in Sepsis:A Systematic Review[J].Curr Pharm Biotechnol,2017,18(6):499.
[12]符仲军,向敏,张钰华,等.2型糖尿病合并冠心病患者胱抑素C和降钙素原的检测及其临床意义[J].中国实用医药,2015,10(20):39.
[13]Picariello C,Lazzeri C,Valente S,et al.Procalcitonin in acute cardiac patients[J].Intern Emerg Med,2011,6(3):245.
[14]王明伟,陈玉林,杨威凤,等.非ST段NSTE-ACS患者血清降钙素原与冠脉病变的相关性分析[J].预防医学,2017,29(8):820.
[2]周梦阳.冠心病患者血清DPP4水平与冠脉病变的关系[D].河北医科大学,2015.
[3]Dai J,Xia B,Wu X.Elevated plasma procalcitonin level predicts poor prognosis of ST elevation myocardial infarction in Asian elderly[J].Scand J Clin Lab Invest,2018,78(1-2):49.
[4]Antman EM,Hand M,Armstrong PW,et al.2007focused update of the ACC/AHA 2004guidelines for the management of patients with ST-elevation myocardial infarction:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2008,51(2):210.
[5]Collet C,Grundeken MJ,Asano T,et al.State of the art:coronary angiography[J].EuroIntervention,2017,13(6):634.
[6]王艺霏,王勇,韩超,等.冠心病患者血清IL-1ra和IL-6水平与冠脉病变程度及预后的相关性研究[J].海南医学,2014,25(20):3017.
[7]仲艳华,罗立波,蒋敬庭,等.冠心病患者血清白介素-17与血管假友病因子、C-反应蛋白水平及冠脉病变程度的相关性[J].中国医药导报,2013,10(17):40.
[8]Liou K,Jepson N,Buckley N,et al.Design and Rationale for the Endothelin-1Receptor Antagonism in the Prevention of Microvascular Injury in Patients with non-ST Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention(EN-DORA-PCI)Trial[J].Cardiovasc Drugs Ther,2016,30(2):169.
[9]杨文英.DPP-4抑制剂维格列汀的心血管效应[J].药品评价,2014,11(9):23.
[10]张雪松,秦明照.GLP-1受体激动剂和DPP-4抑制剂对心血管系统的保护作用[J].临床药物治疗杂志,2013,11(4):42.
[11]Giannakopoulos K,Hoffmann U,Ansari U,et al.The Use of Biomarkers in Sepsis:A Systematic Review[J].Curr Pharm Biotechnol,2017,18(6):499.
[12]符仲军,向敏,张钰华,等.2型糖尿病合并冠心病患者胱抑素C和降钙素原的检测及其临床意义[J].中国实用医药,2015,10(20):39.
[13]Picariello C,Lazzeri C,Valente S,et al.Procalcitonin in acute cardiac patients[J].Intern Emerg Med,2011,6(3):245.
[14]王明伟,陈玉林,杨威凤,等.非ST段NSTE-ACS患者血清降钙素原与冠脉病变的相关性分析[J].预防医学,2017,29(8):820.