摘要
目的 探讨冠心病(CHD)患者甘油三酯-葡萄糖指数(Ty G)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)表达水平,分析上述指标与冠状动脉狭窄程度的关系。方法 选取2022年3月至12月就诊于新疆医科大学第五附属医院确诊CHD并完善冠脉造影检查患者127例。根据冠脉造影结果和Gensini评分将患者分为轻度狭窄组(Gensini评分<36分,n=69)与重度狭窄组(Gensini评分≥36分,n=58)。另选取冠脉造影结果正常的57例受试者为非CHD组。收集研究对象一般临床资料,计算TyG,采用酶联免疫吸附试验检测IL-6、TNF-α水平。采用Logistic回归分析筛选CHD患者冠脉重度狭窄的独立危险因素,采用受试者工作特征(ROC)曲线检验TyG、IL-6、TNF-α以及三者联合预测CHD患者冠脉重度狭窄的价值。结果 重度狭窄组Ty G、IL-6、TNF-α表达水平高于轻度狭窄组、非CHD组;轻度狭窄组IL-6水平高于非CHD组,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,TyG与Gensini评分(r=0.269,P<0.01)、IL-6(r=0.348,P<0.01)、TNF-α(r=0.443,P<0.01)呈正相关。Logistic回归分析结果显示,性别(OR=0.301,95%可信区间:0.104~0.868,P=0.026)、年龄(OR=1.110,95%可信区间:1.044~1.181,P<0.001)、脂蛋白(OR=1.004,95%可信区间:1.001~1.008,P=0.011)、IL-6(OR=1.052,95%可信区间:1.024~1.081,P<0.001)、TyG(OR=3.163,95%可信区间:1.105~9.056,P=0.032)为CHD患者冠脉重度狭窄的独立危险因素。Ty G、IL-6、TNF-α以及三者联合预测CHD患者冠脉重度狭窄的ROC曲线下面积分别为0.656、0.630、0.622、0.677。结论 TyG表达水平与CHD患者IL-6、TNF-α水平及冠状动脉血管病变程度密切相关,TyG可能是CHD的潜在炎性指标。TyG联合IL-6、TNF-α对于预测CHD患者冠脉狭窄程度有一定价值。
Objective To investigate the expression levels of triglyceride-glucose index(TyG),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in patients with coronary artery disease(CHD),and analyze the relationship between the above indexes and the degree of coronary artery stenosis.Methods A total of 127 patients diagnosed with CHD and underwent coronary angiography in the Fifth Affiliated Hospital of Xinjiang Medical University from March to December 2022 were selected.According to the results of coronary angiography and Gensini score,patients were divided into mild stenosis group(Gensini score<36 scores,n=69)and severe stenosis group(Gensini score≥36 scores,n=58).Another 57 subjects with normal coronary angiography results were selected as non-CHD group.General clinical data of the subjects were collected,TyG was calculated,IL-6 and TNF-αlevels were detected by enzyme-linked immunosorbent assay.Independent risk factors for severe coronary artery stenosis in CHD patients were screened by Logistic regression analysis,and the value of TyG,IL-6,TNF-αand their combination in severe coronary artery stenosis in CHD patients was predicted by receiver operating characteristic(ROC)curve.Results The expression levels of TyG,IL-6 and TNF-αin severe stenosis group were higher than those in mild stenosis group and non-CHD group,the level of IL-6 in mild stenosis group was higher than that in non-CHD group,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that TyG was positively correlated with Gensini score(r=0.269,P<0.01),IL-6(r=0.348,P<0.01)and TNF-α(r=0.443,P<0.01).Logistic regression analysis showed that gender[OR=0.301,95%credibility interval(CI)0.104-0.868,P=0.026],age(OR=1.110,95%CI 1.044-1.181,P<0.001),lipoprotein(OR=1.004,95%CI 1.001-1.008,P=0.011),IL-6(OR=1.052,95%CI 1.024-1.081,P<0.001),and TyG(OR=3.163,95%CI 1.105-9.056,P=0.032)were risk factors for severe coronary stenosis in patients with CHD.ROC curve showed that the area under ROC curve of TyG,IL-6,TNF-αand the combination of them were 0.656,0.630,0.622 and 0.677,respectively.Conclusion The expression level of TyG is closely related to the levels of IL-6,TNF-αand the degree of coronary vascular disease in CHD patients,and TyG may be a potential inflammatory indicator of CHD.TyG combined with IL-6 and TNF-αhas certain value in predicting the degree of coronary artery stenosis in CHD patients.
作者
王思晴
徐梦鸽
马巨星
李娇
李霞
WANG Si-qing;XU Meng-ge;Ma Ju-xing;LI Jiao;LI Xia(Department of General Medicine,the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)
出处
《创伤与急危重病医学》
2024年第1期9-13,28,共6页
Trauma and Critical Care Medicine
基金
国家自然科学基金项目(81960073)。
作者简介
第一作者:王思晴(1996-),女,江苏徐州人;通信作者:李霞,E-mail:250456230@qq.com。
