Angptl2 YKL-40和SII水平与高血压合并不稳定型心绞痛患者相关性研究

doi:10.3969/j.issn.1006-6233.2023.07.08

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摘要 目的: 探讨血管紧张素样蛋白2(Angptl2)、甲壳质酶蛋白40(YKL-40)和全身免疫炎症指数(SII)水平在原发性高血压(EH)合并不稳定型心绞痛(UA)诊断中的联合应用价值,并分析其与冠状动脉病变程度的相关性。方法: 收集2020年12月至2021年12月在承德医学院附属医院以EH收治入院的161例患者的临床资料。其中,根据是否合并UA分为EH组(n=76)、EH+UA组(n=85)。分别测定两组患者的血清Angptl2、YKL-40水平,根据相应公式计算得出SII水平。比较各组的一般资料以及Angptl2、YKL-40和SII水平的差异,采用多因素Logistic回归分析EH+UA的独立影响因素,Spearman秩相关分析Angptl2、YKL-40和SII水平与冠状动脉病变程度的相关性,受试者工作特征(ROC)曲线分析Angptl2、YKL-40和SII水平预测EH+UA的敏感度和特异度。结果: EH+UA组低密度脂蛋白胆固醇(LDLC)、超敏C-反应蛋白(hsCRP)、白细胞(WBC)、中性粒细胞计数(Neutrophil)、SII、Angptl2和YKL-40水平高于EH组(均P<0.05);EH+UA组淋巴细胞计数(Lymphocyte)低于EH组(P<0.05)。Angptl2、YKL-40和SII水平可能是EH+UA的独立预测因素(P<0.05)且与Angptl2、YKL-40和SII水平与Gensini积分呈正相关(P<0.05)。SII、Angptl2和YKL-40在EH+UA诊断中的ROC曲线下面积(AUC)分别为0.783、0.789和0.86,三者联合诊断的AUC大于单独SII、Angptl2和YKL-40或两两诊断的AUC(P<0.05)。结论: Angptl2、YKL-40和SII水平的异常上调可能是EH+UA的危险预测因素,高水平Angptl2、YKL-40和SII水平的还可能是评估冠状动脉病变的严重程度的预测指标,且三者联合检测对EH+UA的诊断价值更高。

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关键词 ：原发性高血压, 不稳定性心绞痛, 甲壳质酶蛋白40, 血管紧张素样蛋白2, 全身免疫炎症指数, Gensini积分

Abstract：Objective: To investigate the diagnosis value of combined angiotensin-like protein 2 (Angptl2),chitinase protein 40 (YKL-40) and systemic immune inflammatory index (SII) levels for essential hypertension (EH) combined with unstable angina (UA) and to analyze their correlation with the degree of coronary artery lesions. Methods: The clinical data of 161 patients admitted with EH to the Affiliated Hospital of Chengde Medical University from December 2020 to December 2021 were collected.They were divided into EH group (n=76) and EH+UA group (n=85) according to whether they had UA.The serum Angptl2 and YKL-40 levels were measured separately in the two groups,and the SII levels were calculated according to the corresponding formula.General information and differences in Angptl2,YKL-40 and SII levels were compared between the groups.Multi-factor logistic regression was used to analyse independent influences on EH+UA,Spearman's rank correlation was used to analyse the correlation between Angptl2,YKL-40 and SII levels and the degree of coronary artery disease,and ROC curves were used to analyse the sensitivity and specificity of Angptl2,YKL-40 and SII levels in predicting EH+UA. Results: The levels of low-density lipoprotein cholesterol (LDL-C),supersensitive C-reactive protein (hsCRP),white blood cells (WBC),neutrophil count (Neutrophil),SII,Angptl2 and YKL-40 were higher in the EH+UA group than in the EH group (all P<0.05); the lymphocyte count (Lymphocyte) was lower in the EH+UA group than in the EH group (P<0.05).Angptl2,YKL-40 and SII levels may be independent predictors of EH+UA (P<0.05) and positively correlated with Angptl2,YKL-40 and SII levels and Gensini score (P<0.05).SII,Angptl2 and YKL-40 in the diagnosis of EH+UA.The area under the ROC curve (AUC) was 0.783 (95% CI:0.714-0.853 ),0.789 (95% CI:0.721-0.858 ) and 0.86 (95% CI:0.806-0.914),respectively,and the AUC of the three combined diagnoses was greater than that of SII,Angptl2 and YKL-40 alone or both AUC,and was more sensitive. Conclusion: Abnormal up-regulation of Angptl2,YKL-40 and SII levels may be a risk predictor for EH+UA,and high levels of Angptl2,YKL-40 and SII may also be a predictor for assessing the severity of coronary artery lesions,and the combined test is more valuable for the diagnosis of EH+UA.

Key words： Essential hypertension Unstable angina Chitinase protein 40 Angiotensin-like protein 2 Systemic immunoinflammatory index Gensini score

基金资助:河北省自然科学基金项目,(编号:C2022406011);2022年度承德市科技局基础研究项目,(编号:202205B074)

通讯作者: 侯瑞田

引用本文:

王瑞旭, 金凤表, 李博, 高宇, 林一鹏, 卢艺心, 侯瑞田. Angptl2 YKL-40和SII水平与高血压合并不稳定型心绞痛患者相关性研究[J]. 河北医学, 2023, 29(7): 1099-1104.
WANG Ruixu, JIN Fengbiao, LI Bo, et al. Correlation between Angptl2 YKL-40 and SII Levels and Patients with Hypertension Combined with Unstable Angina Pectoris. HeBei Med, 2023, 29(7): 1099-1104.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.07.08 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I7/1099

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