血清1-磷酸鞘氨醇、神经肽Y与冠状动脉临界病变的关系及对功能性心肌缺血的预测研究

摘要 目的：分析血清1-磷酸鞘氨醇、神经肽Y与冠状动脉（以下简称冠脉）临界病变的关系及对功能性心肌缺血的预测价值。方法：选择我院自2020年1月至2022年6月接诊的148例冠脉临界病变患者作为观察组，根据冠脉粥样硬化斑块易损性，分为易损斑块组（68例）和稳定斑块组（80例）；另选同期的148例非冠脉临界病变的体检者作为对照组。检测所有受试者血清1-磷酸鞘氨醇、神经肽Y水平，比较观察组与对照组、易损斑块组与稳定斑块组血清1-磷酸鞘氨醇、神经肽Y水平，使用Pearson相关性分析血清1-磷酸鞘氨醇、神经肽Y与Gensini评分的关系，通过受试者工作特征曲线（ROC）下面积（AUC）评价血清1-磷酸鞘氨醇联合神经肽Y对功能性心肌缺血的预测效能。结果：观察组血清1-磷酸鞘氨醇、神经肽Y水平均高于对照组（P＜0.05）；易损斑块组血清1-磷酸鞘氨醇、神经肽Y水平均高于稳定斑块组（P＜0.05）；经Pearson相关性分析，冠脉临界病变患者血清1-磷酸鞘氨醇、神经肽Y水平均与Gensini评分呈正相关（P＜0.05）；在148例冠脉临界病变患者中，发生功能性心肌缺血45例；功能性心肌缺血组血清1-磷酸鞘氨醇、神经肽Y水平均高于非功能性心肌缺血组（P＜0.05）；经ROC曲线分析，血清1-磷酸鞘氨醇联合神经肽Y预测冠状动脉临界病变患者发生功能性心肌缺血的AUC为0.928。结论：冠状动脉临界病变患者血清1-磷酸鞘氨醇、神经肽Y水平均明显升高，两者与病情严重程度密切相关，联合预测功能性心肌缺血的准确性较高，值得临床予以重视应用。

Relationship between Serum Sphingosine 1-phosphate and Neuropeptide Y and Critical Coronary Artery Lesions and Prediction of Functional Myocardial Ischemia

ABSTRACT Objective: To analyze the relationship between serum sphingosine 1-phosphate, neuropeptide Y and critical coronary artery lesions and their predictive value for functional myocardial ischemia. Methods: A total of 148 patients with critical coronary artery disease admitted to our hospital from January 2020 to June 2022 were selected as the observation group. According to the vulnerability of coronary atherosclerotic plaque, they were divided into vulnerable plaque group (68 cases) and stable plaque group (80 cases). A total of 148 subjects without critical coronary artery disease were selected as matched group. The serum levels of sphingosine 1-phosphate and neuropeptide Y were detected in all subjects. The serum levels of sphingosine 1-phosphate and neuropeptide Y were compared between observation group and matched group, vulnerable plaque group and stable plaque group. Pearson correlation was used to analyze the relationship between serum sphingosine 1-phosphate and neuropeptide Y and Gensini score. The area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive efficacy of serum sphingosine 1-phosphate combined with neuropeptide Y for functional myocardial ischemia. Results: Serum levels of sphingosine 1-phosphate and neuropeptide Y in the observation group were higher than those in the matched group (P<0.05); serum sphingosine 1-phosphate and neuropeptide Y levels in the vulnerable plaque group were higher than those in the stable plaque group(P<0.05). Pearson correlation analysis showed that serum sphingosine 1-phosphate and neuropeptide Y levels in patients with borderline coronary lesions were positively correlated with Gensini score(P<0.05); among 148 patients with borderline coronary lesions, the There were 45 cases with functional myocardial ischemia; the levels of sphingosine 1-phosphate and neuropeptide Y in the functional myocardial ischemia group were higher than those in the non-functional myocardial ischemia group(P<0.05). The AUC of sphingosine phosphate combined with neuropeptide Y in predicting functional myocardial ischemia in patients with borderline coronary artery disease was 0.928. Conclusion: The serum levels of sphingosine 1-phosphate and neuropeptide Y are increased in patients with critical coronary artery disease, which are closely related to the severity of the disease, the combined prediction of functional myocardial ischemia has a high accuracy, which is worthy of clinical attention.