李颖利,张宝娓,马为,陈明,李建平,洪涛,霍勇

• 1:北京大学第一医院心内科

摘要(Abstract)：

目的探讨血浆骨桥蛋白水平与冠状动脉粥样硬化病变严重程度的相关性,分析骨桥蛋白对于冠心病诊断和远期不良心血管事件的预测价值。方法入选2011年1月1日至2011年12月31日于北京大学第一医院因怀疑冠心病而行冠状动脉造影的患者788例,根据冠状动脉造影检查中所见冠状动脉受累情况由轻到重将患者分为无病变组(38例)、冠状动脉粥样硬化组(119例)、单支病变组(172例)、双支病变组(189例)及三支±左主干病变组(270例)。用酶联免疫吸附测定(ELISA)法测定血浆骨桥蛋白浓度,分析血浆骨桥蛋白水平与冠状动脉病变的相关性,行受试者工作特征(ROC)曲线下面积分析骨桥蛋白对冠心病的预测价值并与冠心病的传统危险因素进行对比,分析血浆骨桥蛋白水平与患者预后的相关性。结果无病变、冠状动脉粥样硬化、单支病变、双支病变及三支±左主干病变5组的平均血浆骨桥蛋白浓度分别为(37.05±15.23)、(51.01±18.81)、(66.26±23.22)、(76.92±26.39)和(88.14±28.93)μg/L;血浆骨桥蛋白水平与冠状动脉病变血管受累情况的相关系数r=0.511,P<0.001;骨桥蛋白预测冠心病的ROC曲线下面积为0.821,而冠心病的6个传统危险因素预测冠心病的ROC曲线下面积为0.692;随访发现,血浆骨桥蛋白水平≤71.55μg/L者发生复合终点事件79例(20.1%),血浆骨桥蛋白水平>71.55μg/L者发生复合终点事件118例(29.9%),差异有统计学意义(P=0.001)。结论随着冠状动脉粥样硬化病变程度的增加,血浆骨桥蛋白水平也随之升高;血浆骨桥蛋白水平对于冠心病诊断有较好的预测价值,对于冠心病患者的预后可能存在一定的预测价值。

关键词(KeyWords)： 冠心病;冠状动脉粥样硬化;骨桥蛋白;诊断;预后

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李颖利,张宝娓,马为,陈明,李建平,洪涛,霍勇

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