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冠状动脉搭桥术中血清白蛋白水平及单核细胞与高密度脂蛋白胆固醇比值与大隐静脉移植血管病变的关系

Relationship between Serum Albumin Level and Monocyte-to-High-Density Lipoprotein Cholesterol Ratio with Saphenous Vein Graft Disease in Coronary Bypass.

作者信息

Akboga Mehmet Kadri, Yayla Cagri, Balci Kevser Gulcihan, Ozeke Ozcan, Maden Orhan, Kisacik Halil, Temizhan Ahmet, Aydogdu Sinan

机构信息

Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.

出版信息

Thorac Cardiovasc Surg. 2017 Jun;65(4):315-321. doi: 10.1055/s-0036-1582260. Epub 2016 Apr 25.

Abstract

Previous studies proposed that inflammation, oxidative stress, and impaired endothelial dysfunction have a crucial role in occurrence of saphenous vein graft (SVG) disease (SVGD). The aim of this study was to assess the relationship between monocyte-to-high-density lipoprotein cholesterol (HDL-C) ratio (MHR) and serum albumin (SA) level as readily available inflammatory and oxidative stress markers with the presence of SVGD in patients with a coronary bypass.  In this retrospective cross-sectional study, a total of 257 patients ( = 112 SVGD [+] [mean age was 65.3 ± 8.4 years, 75.0% males] and  = 145 SVGD [-] [mean age was 66.5 ± 10.1 years, 74.5% males]) were enrolled. At least one SVG with ≥ 50% stenosis was defined as SVGD. Independent predictors of SVGD were determined by logistic regression analysis.  White blood cell, neutrophil, monocyte, the age of SVG, and MHR were significantly higher, whereas SA level was significantly lower in patients with SVGD. In regression analysis, neutrophil, age of SVG, SA (odds ratio [OR]: 0.232 [0.156-0.370],  < 0.001), and MHR (OR: 1.122 [1.072-1.174],  < 0.001) remained as independent predictors of SVGD. Moreover, age of SVG showed a significant negative correlation with SA ( = - 0.343,  < 0.001) and a positive correlation with MHR ( = 0.238,  < 0.001). In the receiver-operating characteristic curve analysis, the cutoff value of ≤ 3.75 g/dL for SA has a 73.2% sensitivity and 64.8% specificity and the cutoff value of ≥ 12.1 for MHR has a 71.4% sensitivity and 60.0% specificity for prediction of SVGD.  Consequently, to the best of our knowledge, this is the first study showing a significant and independent association between SA and MHR with SVGD.

摘要

以往研究表明,炎症、氧化应激和内皮功能障碍受损在大隐静脉移植血管(SVG)疾病(SVGD)的发生中起关键作用。本研究旨在评估单核细胞与高密度脂蛋白胆固醇(HDL-C)比值(MHR)和血清白蛋白(SA)水平作为易于获得的炎症和氧化应激标志物与冠状动脉搭桥患者中SVGD存在情况之间的关系。在这项回顾性横断面研究中,共纳入了257例患者(n = 112例SVGD [+] [平均年龄为65.3±8.4岁,75.0%为男性]和n = 145例SVGD [-] [平均年龄为66.5±10.1岁,74.5%为男性])。至少有一条狭窄≥50%的SVG被定义为SVGD。通过逻辑回归分析确定SVGD的独立预测因素。SVGD患者的白细胞、中性粒细胞、单核细胞、SVG的年龄和MHR显著更高,而SA水平显著更低。在回归分析中,中性粒细胞、SVG的年龄、SA(比值比[OR]:0.232 [0.156 - 0.370],P < 0.001)和MHR(OR:1.122 [1.072 - 1.174],P < 0.001)仍然是SVGD的独立预测因素。此外,SVG的年龄与SA呈显著负相关(r = - 0.343,P < 0.001),与MHR呈正相关(r = 0.238,P < 0.001)。在受试者工作特征曲线分析中,SA≤3.75 g/dL的临界值对SVGD预测的敏感性为73.2%,特异性为64.8%,MHR≥12.1的临界值对SVGD预测的敏感性为71.4%,特异性为60.0%。因此,据我们所知,这是第一项显示SA和MHR与SVGD之间存在显著且独立关联的研究。

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