摘要
目的探讨冠心病患者血清丙氨酸氨基转移酶(ALT)与冠状动脉粥样硬化病变程度的相关性。方法选取608例首次完善冠脉造影检查的住院患者。研究对象分为对照组(35例,冠脉造影血管狭窄<50%)和冠心病组(573例,至少一支冠脉血管狭窄≥50%),冠心病组研究对象均纳入初次诊断为心绞痛的患者。冠心病组根据冠脉病变评分(Gensini评分)中位数,分为低评分组(292例,2～25分)和高评分组(281例,26～192分),进行一般资料的收集,血液学肝功能、肾功能、血脂分析等检测,分析冠心病患者血清ALT水平增高与冠状动脉粥样硬化程度的相关性。结果冠心病组研究对象的Gensini评分、ALT水平、碱性磷酸酶(ALP)、非结合胆红素和血清胱抑素C均高于对照组,冠心病组球蛋白(GLB)低于对照组(P<0.05)。Gensini高评分组ALT、天门冬氨酸氨基转移酶(AST)、ALP、总蛋白、GLB、γ-谷氨酰转移酶、肌酸激酶、肌酸激酶同工酶MB和5′-核苷酸酶高于低分组,高分组直接胆红素及渗透压低于低分组(P<0.05)。ALT升高组的冠脉病变高分比例显著增高(P<0.05)。在ALT正常水平组中,在ALT水平正常的冠心病患者中,血清ALT水平增高与Gensini评分有独立相关性。对数转换的ALT(OR值:4.702,95%CI:2.502～4.644)。结论在ALT水平正常的冠心病患者中,ALT水平的增高是冠脉病变程度的独立危险因素。
ObjectiveTo investigate the relationship between ALT and severity of coronary atherosclerosis in patients with coronary heart disease(CHD).Methods608 hospitalized patients who first completed coronary angiography were selected.The subjects were divided into control group(35 cases,coronary angiographic stenosis<50%)and coronary heart disease group(573 cases,at least one coronary artery stenosis≥50%).The subjects of coronary heart disease group were included in the patients who were first diagnosed as angina pectoris.According to the median of Gensini score,CHD group was divided into low score group(292 cases,2-25 points)and high score group(281 cases,26-192 points).General data were collected,hematological liver function,renal function and lipid analysis were carried out to analyze the correlation between serum ALT level and the degree of CHD.ResultsGensini score,ALT,IBIL,ALP and Cystatin C in CHD group were higher than those in control group,while GLB in CHD group was lower than that in control group(P<0.05).ALT,AST,ALP,TP,GLB,GGT,CK,CK-MB and 5′-NT in Gensini high score group were higher than those in low score group,DBIL and osmotic pressure in high score group were lower than those in low score group(P<0.05).The high score of coronary artery lesion in ALT elevated group was significantly higher than that in ALT elevated group(P<0.05).In the normal ALT level group,the increase of serum ALT level was independently correlated with Gensini score in CHD patients with normal ALT level.The ALT of logarithmic transformation(OR value:4.702,95%CI:2.502-4.644).ConclusionIncreased ALT level is an independent risk factor for the severity of coronary artery disease in patients with normal ALT level.
作者
佴志慧
邢智
阿丽米拉.赛依提江
曹世雄
高颖
NAI Zhihui;XING Zhi;Alimila Saiyitijiang;CAO Shixiong;GAO Ying(Department of The Second Ward of Card,The First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China)
出处
《新疆医科大学学报》
CAS
2019年第3期288-292,共5页
Journal of Xinjiang Medical University
基金
国家自然科学基金(8166020046)
作者简介
佴志慧(1994-),女,硕士,研究方向:脂源性激素代谢;通信作者:高颖,女,博士,主任医师,教授,博士生导师,研究方向:脂肪激素与心血管疾病、糖尿病、肥胖关系,E-mail:sunflower@163.com。
