糖化清蛋白、高敏C反应蛋白与冠心病临界病变患者冠脉斑块形态学特征的关系及对功能性心肌缺血的预测研究

摘要 目的：分析糖化清蛋白、高敏C反应蛋白与冠心病临界病变患者冠脉斑块形态学特征的关系及对功能性心肌缺血的预测价值。方法：选择自2020年1月至2022年6月我院经冠脉造影确诊的165例冠心病临界病变患者作为研究对象，分为不稳定型心绞痛组和稳定型心绞痛组。检测两组血清糖化清蛋白、高敏C反应蛋白表达水平，使用靶血管造影检测冠脉斑块形态学指标，Pearson相关性分析血清糖化清蛋白、高敏C反应蛋白与冠脉斑块形态学指标的关系，通过ROC曲线下面积（AUC）评价血清糖化清蛋白联合高敏C反应蛋白对功能性心肌缺血的预测价值。结果：不稳定型心绞痛组血清糖化清蛋白、高敏C反应蛋白表达水平均高于稳定型心绞痛组（P＜0.05）；不稳定型心绞痛组最小管腔直径、最小管腔面积均小于稳定型心绞痛组，直径狭窄率、管腔面积狭窄率、斑块面积均大于稳定型心绞痛组（P＜0.05）；在165例冠心病临界病变患者中，发生冠脉易损斑块53例；易损斑块组血清糖化清蛋白、高敏C反应蛋白表达水平均高于非易损斑块组（P＜0.05）；经Pearson相关性分析，冠心病临界病变患者血清糖化清蛋白、高敏C反应蛋白表达水平均与最小管腔直径、最小管腔面积呈负相关，与直径狭窄率、管腔面积狭窄率、斑块面积呈正相关（P＜0.05）；经ROC曲线分析，血清糖化清蛋白联合高敏C反应蛋白预测冠心病临界病变患者发生功能性心肌缺血的AUC为0.910。结论：糖化清蛋白、高敏C反应蛋白与冠心病临界病变患者冠脉斑块形态学特征密切相关，有助于评估冠脉斑块易损性，联合预测功能性心肌缺血的效能较好，值得临床予以重视应用。

Relationship between Glycated Albumin, High Sensitivity C-reactive Protein and the Morphological Characteristics of Coronary Plaques in Patients with Critical Lesions of Coronary Heart Disease and Prediction of Functional Myocardial Ischemia

ABSTRACT Objective: To analyze the relationship between glycated albumin,high sensitivity C-reactive protein and the morphological characteristics of coronary plaques in patients with critical lesions of coronary heart disease and their predictive value for functional myocardial ischemia. Methods: From January 2020 to June 2022, 165 patients with critical lesions of coronary heart disease diagnosed by coronary angiography in our hospital were selected as the research objects.They were divided into unstable angina group and stable angina group. The expression levels of serum glycosylated albumin and high sensitivity C-reactive protein in the two groups were detected, and the morphological indexes of coronary plaques were detected by target angiography. Pearson correlation analysis was performed to analyze the relationship between serum glycosylated albumin, high sensitivity C-reactive protein and the morphological indexes of coronary plaques. The area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive value of serum glycosylated albumin combined with high sensitivity C-reactive protein for functional myocardial ischemia. Results: The levels of serum glycosylated albumin and high sensitivity C-reactive protein in unstable angina group were higher than those in stable angina group (P<0.05). The minimum lumen diameter and minimum lumen area of the unstable angina group were smaller than those of the stable angina group, and the diameter stenosis rate, lumen area stenosis rate and plaque area of the unstable angina group were larger than those of the stable angina group(P<0.05). Among 165 patients with critical lesions of coronary heart disease, 53 patients developed vulnerable plaques. The expression levels of serum glycosylated albumin and high sensitive C-reactive protein in vulnerable plaque group were higher than those in non-vulnerable plaque group(P<0.05). Pearson correlation analysis showed that the expression levels of serum glycosylated albumin and high-sensitivity C-reactive protein were negatively correlated with minimum lumen diameter and minimum lumen area, and positively correlated with diameter stenosis rate, lumen area stenosis rate and plaque area (P<0.05). ROC curve analysis showed that the AUC of serum glycosylated albumin combined with high sensitivity C-reactive protein in predicting functional myocardial ischemia in patients with borderline coronary heart disease was 0.910. Conclusion: Glycosylated albumin and high sensitivity C-reactive protein are closely related to the morphological characteristics of coronary plaques in patients with critical lesions of coronary heart disease, they are helpful to evaluate the vulnerability of coronary plaques, the combined prediction of functional myocardial ischemia has good efficacy, which is worthy of clinical attention.