前列环素、神经肽Y与冠状动脉临界病变的关系及对近期功能性心肌缺血的预测研究

摘要 目的：探讨与研究前列环素（PGI）、神经肽Y（NPY）与冠状动脉临界病变的关系及对近期功能性心肌缺血的预测价值。方法：选择2018年8月到2021年9月本院诊治的80例冠状动脉临界病变患者与80例冠状动脉病变患者分别作为临界组与病例组，同期选择在本院体检的正常冠状动脉人群80例作为正常组，检测三组前列环素、神经肽Y表达水平并进行相关性分析。随访冠状动脉临界病变患者的近期预后并进行功能性心肌缺血的预测分析。结果：病例组、临界组的血清前列环素含量低于正常组，血清神经肽Y含量高于正常组，病例组与临界组对比有明显差异（P<0.05）。病例组、临界组的生理维度、社会维度、心理维度、环境维度等生命质量评分明显低于正常组，病例组也低于临界组（P<0.05）。在240例人群中，Pearson相关性分析显示血清前列环素、神经肽Y含量与冠状动脉临界病变的发生存在相关性（P<0.05）。多因素logistic回归分析显示前列环素、神经肽Y为导致冠状动脉临界病变发生的重要因素（P<0.05）。所有临界组患者预后随访到2022年4月，平均随访时间为31.02±2.58个月，发生功能性心肌缺血21例，发生率为26.3 %。接收者操作特征（ROC）曲线分析显示血清前列环素、神经肽Y预测功能性心肌缺血的曲线下面积分别为0.828、0.836。结论：冠状动脉临界病变患者多伴随有前列环素、神经肽Y表达异常，可导致生命质量下降，前列环素、神经肽Y与冠状动脉临界病变存在相关性，两者预测近期功能性心肌缺血的发生具有很好的价值。

The Relationship between Prostacyclin, Neuropeptide Y and Critical Coronary Lesions and Prediction of Recent Functional Myocardial Ischemia

ABSTRACT Objective: To explore and study the relationship between Prostacyclin (PGI), neuropeptide Y (NPY) and critical coronary lesions and their predictive values for recent functional myocardial ischemia. Methods: From August 2018 to September 2021, 80 cases of patients with borderline coronary artery disease and 80 cases of patients with coronary artery disease who were diagnosed and treated in our hospital were selected as the borderline group and the case group, respectively, and the other 80 cases of patients with normal coronary artery who underwent physical examination in our hospital during the same period were selected as the normal group. The expression levels of prostacyclin and neuropeptide Y in the three groups were detected and the correlation analysis were carried out. To follow up the short-term prognosis of patients with borderline coronary artery disease and perform predictive analysis of functional myocardial ischemia. Results: The serum prostacyclin content of the case group and the borderline group were lower than that of the normal group, and the serum neuropeptide Y content were higher than that of the normal group (P<0.05). There were significant difference between the case group and the borderline group (P<0.05). The quality of life scores of the case group and the borderline group were significantly lower than those of the normal group, and the case group were also lower than the borderline group (P<0.05). In the 240 cases, Pearson correlation analysis showed that serum prostacyclin and neuropeptide Y levels were correlated with the occurrence of borderline coronary artery lesions (P<0.05). Multivariate logistic regression analysis showed that prostacyclin and neuropeptide Y were important factors leading to critical coronary lesions (P<0.05). All patients in the borderline group were followed up until April 2022, with an average follow-up time of 31.02±2.58 months. There were 21 cases of functional myocardial ischemia occurred in the 80 cases, with an incidence rate of 26.3 %. The receiver operating characteristic curve (ROC) curve analysis showed that the areas under the curve of serum prostacyclin and neuropeptide Y in predicting functional myocardial ischemia were 0.828 and 0.836, respectively. Conclusion: Patients with borderline coronary artery lesions are often accompanied by abnormal expressions of prostacyclin and neuropeptide Y, which can lead to decline in the quality of life. There are correlation between prostacyclin and neuropeptide Y and borderline coronary artery lesions, and they both have good values for predicting short-term functional myocardial ischemia.