| 摘要: |
| 目的：探讨心肌声学造影(MCE)结合血清γ-谷氨酰转移酶(γ-GT)、成纤维细胞生长因子21(FGF21)、胰岛素样生长因子-1(IGF-I)对于冠心病(CHD)患者冠状动脉病变狭窄程度预测价值。方法：选择2020年3月至2022年3月于本院收治的68例CHD患者为研究组,并选取同期68例疑似但行冠脉造影排除冠心病的患者作为对照组,所有受试者均行选择性冠状动脉血管造影术(CAG)、MCE检查以及血清γ-GT、FGF21、IGF-I水平检测。以CAG检查结果作为诊断冠状动脉狭窄程度的金标准,比较研究组与对照组,以及CHD患者中不同狭窄程度下MCE定量参数以及血清γ-GT、FGF21、IGF-I水平的差异。通过绘制受试者工作特征曲线(ROC)并计算曲线下面积(AUC),比较MCE、血清γ-GT、FGF21、IGF-I单独及联合诊断CHD患者冠状动脉重度狭窄的诊断效能。结果：CHD患者研究组MCE定量参数(A值、β值及MBF值)、血清FGF21、IGF-I水平显著低于对照组(P<0.05),而血清γ-GT水平显著高于对照组(P<0.05)。CHD患者重度狭窄组的MCE定量参数(A值、β值及MBF值)、血清FGF21、IGF-I水平显著低于中度狭窄组、轻度狭窄组(P<0.05),中度狭窄组值显著低于轻度狭窄组(P<0.05)；而重度狭窄组的血清γ-GT水平显著高于中度狭窄组、轻度狭窄组(P<0.05),中度狭窄组显著高于轻度狭窄组(P<0.05)。与MCE、血清γ-GT、FGF21、IGF-I单独诊断相比较,MCE结合血清γ-GT、FGF21、IGF-I联合诊断CHD患者冠状动脉重度狭窄的AUC(0.918)、敏感度(93.48%)和特异度(89.72%)最高(P<0.05)。结论：MCE联合血清γ-GT、FGF21、IGF-I水平有助于提高对CHD患者冠状动脉重度狭窄的诊断效能,进一步指导临床治疗方案的选择以及改善患者预后提供客观真实的影像学和实验室检查证据。 |
| 关键词: 冠心病 冠状动脉病变 狭窄程度 心肌声学造影 γ-GT、FGF21、IGF-I 预测价值 |
| DOI： |
| 投稿时间：2023-01-21修订日期：2023-04-11 |
| 基金项目:天津市慢性疾病防治科技重大专项(16ZXMJSY00160);天津市重大疾病防治科技重大专项(18ZXDBSY00160)；天津市胸科医院2018年院级课题(2018XKZ02) |
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| Study on the predictive value of myocardial contrast echocardiography combined with serum γ-GT, FGF21 and IGF-I for degree of coronary artery stenosis in patients with coronary heart disease |
| Lin Menghua,chenlanhua,chenrong,Ke Yousen,Xu Di |
| (Department of Ultrasound Diagnosis,900th Hospital of Joint Logistics Support Force of People''s Liberation Army,Fuzhou,Fujian,350001) |
| Abstract: |
| Objective:To investigate the value of myocardial contrast echocardiography ( MCE ) combined with serum γ-glutamyl transferase (γ-GT), fibroblast growth factor 21 (FGF21) and insulin-like growth factor-1 ( IGF-I ) in predicting the degree of coronary artery stenosis in patients with coronary heart disease.Methods: 68 patients with CHD admitted to our hospital from March 2020 to March 2022 were selected as the study group, and 68 patients with suspected coronary artery disease excluded by coronary angiography were selected as the control group. All subjects underwent selective coronary angiography (CAG), MCE and serum γ-GT, FGF21, IGF-I level detection.The differences of MCE quantitative parameters and serumγ-GT, FGF21 and IGF-I levels between the study group and the control group, as well as CHD patients with different stenosis degrees were compared by using the results of CAG as the gold standard for diagnosing the degree of coronary artery stenosis.The diagnostic efficacy of MCE, serum γ-GT, FGF21, IGF-I alone and in combination in the diagnosis of severe coronary artery stenosis in CHD patients was compared by drawing the receiver operating characteristic curve (ROC) and calculating the area under the curve (AUC).Results:The quantitative parameters of MCE (A value, β value and MBF value), serum FGF21 and IGF-I levels in the study group of patients with coronary heart disease were significantly lower than those in the control group (P<0.05), while the serum γ-GT level was significantly higher than that in the control group (P<0.05). <0.05). The MCE quantitative parameters (A value, β value and MBF value), serum FGF21 and IGF-I levels in the severe stenosis group in patients with coronary heart disease were significantly lower than those in the moderate stenosis group and mild stenosis group (P<0.05). The serum γ-GT level in the severe stenosis group was significantly higher than that in the moderate stenosis group and the mild stenosis group (P<0.05), and the moderate stenosis group was significantly higher than the mild stenosis group. degree of stenosis group (P<0.05). Compared with MCE, serum γ-GT, FGF21 and IGF-I alone, MCE combined with serum γ-GT, FGF21 and IGF-I to diagnose severe coronary stenosis in patients with coronary heart disease with AUC (0.918), sensitivity (93.48%) ) and the highest specificity (89.72%) (P<0.05).Conclusion: MCE combined with serum levels of γ-GT, FGF21, and IGF-I can help improve the diagnostic efficiency of severe coronary stenosis in patients with coronary heart disease, further guide the selection of clinical treatment options, and improve patient prognosis. Provide objective and real imaging and laboratory tests evidence. |
| Key words: :Coronary heart disease Coronary artery disease Degree of stenosis Myocardial contrast echocardiography γ-GT FGF21 IGF-I Predictive value |
