冠心病患者血浆CD69、DKK-1与血脂、炎性因子的关系及其诊断价值分析

摘要 目的：分析冠心病（CHD）患者血浆CD69、Wnt拮抗剂蛋白-1（DKK-1）与血脂、炎性因子的关系，并分析CD69和DKK1对于CHD患者的诊断价值。方法：选取2016年6月~2018年12月在我院诊治的CHD患者136例，根据Gensini评分分为轻度亚组、中度亚组、重度亚组，同时纳入与之年龄、性别匹配的冠状动脉造影正常者136例作为对照组。检测受试者血清炎性因子、血脂、及血浆CD69、DKK-1水平，分析CHD患者CD69、DKK-1水平与血脂、炎性因子、Gensini评分的相关性，采用受试者工作特征（ROC）曲线分析CD69和DKK1对于CHD患者的诊断价值。结果：CHD患者CD69、DKK-1、白细胞介素-10（IL-10)、白细胞介素-6（IL-6）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）水平高于对照组，高密度脂蛋白（HDL）水平低于对照组（P<0.05）；随着冠脉狭窄病变程度的加重，CD69、DKK-1、IL-10、IL-6、TC、TG、LDL水平呈升高趋势，HDL水平呈降低趋势（P<0.05）。CHD患者CD69、DKK-1水平与IL-10、IL-6、TC、TG、LDL、Gensini评分均呈正相关，与HDL呈负相关（P<0.05）。ROC曲线分析结果显示，CD69、DKK-1联合检测诊断CHD的灵敏度、特异度分别为0.816、0.846。结论：CHD患者血浆DKK-1、CD69水平升高，与血脂、炎性因子和Gensini评分密切相关，两者联合检测可提高CHD诊断效能。

The Relationship between Plasma CD69, DKK-1 and Blood Lipid and Inflammatory Factors in Patients with Coronary Heart Disease and Its Diagnostic Value

ABSTRACT Objective: To analyze the relationship between plasma CD69, Dickkopf-1 (DKK-1) and blood lipid, inflammatory factors in patients with coronary heart disease (CHD), and to analyze the diagnostic value of CD69 and DKK1 for CHD patients. Methods: 136 cases of CHD patients who were treated in our hospital from June 2016 to December 2018 were collected. They were divided into mild subgroup, moderate subgroup, and severe subgroup according to Gensini score, and 136 cases of normal coronary angiography matched with age and sex were included as control group. Serum inflammatory factors, blood lipids, plasma CD69 and DKK-1 levels were measured. The correlation between CD69 and DKK-1 levels and blood lipids, inflammatory factors and Gensini scores in CHD patients were analyzed. The diagnostic value of CD69 and DKK-1 for CHD patients was analyzed by receiver operating characteristics (ROC) curve. Results: The levels of CD69, DKK-1, interleukin-10 (IL-10), interleukin-6 (IL-6), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) in CHD patients were higher than those in the control group (P<0.05). With the aggravation of coronary stenosis, the levels of CD69, DKK-1, IL-10, IL-6, TC, TG and LDL increased, and the level of HDL decreased (P<0.05). The levels of CD69 and DKK-1 in CHD patients were positively correlated with IL-10, IL-6, TC, TG, LDL and Gensini scores, but they were negatively correlated with HDL(P<0.05). The results of ROC curve analysis showed that the sensitivity and specificity of CD69 and DKK-1 in the diagnosis of CHD were 0.816 and 0.846. Conclusion: The plasma levels of DKK-1 and CD69 in patients with CHD are increased, which are closely related to blood lipid, inflammatory factors and Gensini score. The combined detection of DKK-1 and CD69 can improve the diagnostic efficiency of CHD.