文章摘要
谢记文,龙晓莉,周 鹏,马 惠,谢 静.老年冠心病患者的颈动脉超声特征与胆红素血脂综合指数、斑块稳定性的相关性分析[J].,2024,(3):562-567
老年冠心病患者的颈动脉超声特征与胆红素血脂综合指数、斑块稳定性的相关性分析
Correlation Analysis of Carotid Ultrasound Features, Bilirubin Lipid Index and Plaque Stability in Elderly Patients with Coronary Heart Disease
投稿时间:2023-08-15  修订日期:2023-09-11
DOI:10.13241/j.cnki.pmb.2024.03.031
中文关键词: 冠心病  颈动脉超声特征  胆红素血脂综合指数  斑块稳定性
英文关键词: Coronary heart disease  Carotid ultrasound characteristics  Bilirubin lipid composite index  Patch stability
基金项目:甘肃省科技计划资助项目(21YF5FA164)
作者单位E-mail
谢记文 兰州市第一人民医院功能科 甘肃 兰州 730050 xjw196801@163.com 
龙晓莉 兰州市第一人民医院功能科 甘肃 兰州 730050  
周 鹏 兰州市第一人民医院功能科 甘肃 兰州 730050  
马 惠 兰州市中医医院功能科 甘肃 兰州 730050  
谢 静 兰州市第一人民医院功能科 甘肃 兰州 730050  
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中文摘要:
      摘要 目的:探讨老年冠心病患者的颈动脉超声特征与胆红素血脂综合指数、斑块稳定性的相关性。方法:选择2021年1月至2022年12月来我院诊治的冠心病患者120例。检测所有患者的TC、LDL-C、HDL-C、TBIL、血清I型前胶原羧基端前肽、组织蛋白酶K、基质金属蛋白酶-1、基质金属蛋白酶-9水平,并行颈动脉超声进行检查,确定颈动脉内膜中层厚度,同时行冠状动脉造影,确定冠状动脉病变支数及冠状动脉病变积分。分析不同冠状动脉病变组的颈动脉块数、颈总动脉的超声血流参数及生化指标水平,分析不同颈动脉内膜中层厚度患者的生化指标水平,分析不同冠状动脉病变积分患者的生化指标水平,分析120例冠心病患者颈动脉超声特征及胆红素血脂综合指数、血清斑块稳定性指标的相关性。结果:三支病变组的颈动脉内膜中层厚度、Gokmen积分、TC/(HDL-C+TBIL)、LDL-C/(HDL-C+TBIL)、I型前胶原羧基端前肽、组织蛋白酶K、基质金属蛋白酶-1、基质金属蛋白酶-9水平明显较单支及双支病变组高,双支病变组的以上指标明显较单支病变组高(P均<0.05),单病变组的TBIL明显较双支及三支高(P<0.05),其在双支及三支病变组间无统计学意义(P>0.05)。内膜正常组的TC/(HDL-C+TBIL)、LDL-C/(HDL-C+TBIL)、I型前胶原羧基端前肽、组织蛋白酶K、基质金属蛋白酶-1、基质金属蛋白酶-9水平明显较内膜增厚组及斑块形成组高,内膜增厚组以上指标明显较斑块形成组高(P均<0.05),内膜正常组的TBIL明显较内膜增厚组与斑块形成组高(P<0.05),而内膜增厚组与斑块形成组间对比无统计学意义(P>0.05)。冠状动脉病变积分≤5分组的TC/(HDL-C+TBIL)、LDL-C/(HDL-C+TBIL)、I型前胶原羧基端前肽、组织蛋白酶K、基质金属蛋白酶-1、基质金属蛋白酶-9水平明显较6~10分组及11~15分组高,6~10分组以上指标明显较11~15分组高(P均<0.05),≤5分组的TBIL明显较6~10分组与11~15分组高(P<0.05),而在6~10分组与11~15分组间对比无差异(P>0.05)。不同组间的TC、LDL-C、HDL-C水平对比无统计学意义(P>0.05)。颈动脉内膜中层厚度、Gokmen积分与TC/(HDL-C+TBIL)、LDL-C/(HDL-C+TBIL)、I型前胶原羧基端前肽、组织蛋白酶K、基质金属蛋白酶-1、基质金属蛋白酶-9水平均呈正比(P<0.05);颈动脉内膜中层厚度、Gokmen积分与TC、LDL-C、HDL-C、TBIL水平无相关性(P>0.05)。结论:老年冠心病患者的冠状动脉病变越严重,其颈动脉超声特征、胆红素血脂综合指数、斑块稳定性不断恶化,颈动脉超声特征指标与胆红素血脂综合指数、斑块稳定性指标水平呈正相关。
英文摘要:
      ABSTRACT Objective: To investigate the correlation between carotid ultrasound features, bilirubin lipid composite index and plaque stability in elderly patients with coronary heart disease. Methods: 120 patients with coronary heart disease were selected from January 2021 to December 2022. The levels of TC, LDL-C, HDL-C, TBIL, carboxy-terminal propeptide of serum type I procollagen, cathepsin K, matrix metalloproteinase-1 and matrix metalloproteinase-9 were detected in all patients. Carotid artery ultrasound was performed to determine carotid intima-media thickness, and coronary angiography was performed at the same time. The number of coronary artery disease and coronary artery disease score were determined. Carotid block number, ultrasonic blood flow parameters and biochemical indexes of common carotid artery were analyzed in different coronary artery disease groups, biochemical indexes of patients with different carotid intima-media thickness and biochemical indexes of patients with different coronary artery disease scores were analyzed. The correlation of carotid ultrasound features, bilirubin lipid index and serum plaque stability index in 120 patients with coronary heart disease was analyzed. Results: The levels of carotid intima-media thickness, Gokmen score, TC/ (HDL-C+TBIL), LDL-C/ (HDL-C+TBIL), carboxy-terminal propeptide, cathepsin K, matrix metalloproteinase-1 and matrix metalloproteinase-9 in the three-vessel disease group were higher than those in the single-vessel and double-vessel disease groups. The above indexes in the double-branch disease group were higher than those in the single-branch disease group(P<0.05), and the TBIL in the single-branch disease group was higher than that in the double-branch disease group and the triple-branch disease group(P<0.05), while there were no significance between the double-branch disease group and the triple-branch disease group (P>0.05). The levels of TC/ (HDL-C+TBIL), LDL-C/ (HDL-C+TBIL), carboxy-terminal propeptide of type I procollagen, cathepsin K, matrix metalloproteinase-1 and matrix metalloproteinase-9 in the normal intima group were higher than those in the intima thickening and plaque formation groups. The above indexes in the intima thickening group were higher than those in the plaque formation group(P<0.05), and the TBIL in the normal intima group was higher than that in the intima thickening group and the plaque formation group(P<0.05), but there was no significance between the intima thickening group and the plaque formation group (P>0.05). The levels of TC/ (HDL-C+TBIL), LDL-C/ (HDL-C+TBIL), carboxy-terminal propeptide of type I procollagen, cathepsin K, matrix metalloproteinase-1 and matrix metalloproteinase-9 in group with coronary artery disease score ≤5 were higher than those in group 6-10 and group 11-15. The above indexes in group 6-10 were higher than those in group 11-15(P<0.05), and the TBIL in group ≤5 was higher than that in group 6-10 and group 11-15(P<0.05), but there was no statistical significance between group 6-10 and group 11-15 (P>0.05). There was no difference in the levels of TC, LDL-C and HDL-C among different groups (P>0.05). Carotid intima-media thickness and Gokmen score were positively correlated with the levels of TC/ (HDL-C+TBIL), LDL-C/ (HDL-C+TBIL), carboxy-terminal propeptide of type I procollagen, cathepsin K, matrix metalloproteinase-1 and matrix metalloproteinase-9(P<0.05). Carotid intima-media thickness and Gokmen score had no correlation with TC, LDL-C, HDL-C and TBIL levels (P>0.05). Conclusion: The more severe the coronary artery lesions in elderly patients with coronary heart disease, the carotid ultrasound characteristics, bilirubin lipid index and plaque stability continue to deteriorate, and the carotid ultrasound characteristics are positively correlated with the levels of bilirubin lipid index and plaque stability index.
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