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缺血修饰白蛋白水平与冠状动脉侧支循环的相关性。

Correlation between ischemia-modified albumin level and coronary collateral circulation.

机构信息

Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.

出版信息

BMC Cardiovasc Disord. 2020 Jul 8;20(1):326. doi: 10.1186/s12872-020-01543-9.

Abstract

OBJECTIVE

To investigate the correlation between ischemia-modified albumin (IMA) levels and coronary collateral circulation (CCC) in patients with chronic total occlusive (CTO).

METHODS

Coronary angiography was performed in the Department of Cardiology, Zhongnan Hospital of Wuhan University from 2017 to 08 to 2019-02 to identify 128 patients with CTO lesions in at least one major coronary artery. According to the Rentrop evaluation criteria, the degree of CCC formation was divided into the poor CCC formation group (Rentrop0-1 grade,n = 69) and the good CCC formation group (Rentrop2-3 grade,n = 59). The IMA level of the patients was measured using an albumin-cobalt binding assay. The general data, routine blood panel, total bilirubin (TBIL), blood lipids, uric acid (UA), left ventricular ejection fraction (LVEF) and other indicators of the patients were recorded and analyzed while assessing the patients' blood vessel occlusion.

RESULTS

The proportion of platelet count and diabetes in the poor CCC group was higher than that in the good CCC group (P < 0.05). The ratio of ischemia-modified albumin and total bilirubin in the poor CCC group was lower than that in the good CCC group (P < 0.05). Multivariate logistic regression analysis showed that ischemia-modified albumin was positively correlated with CCC formation [OR = 1.190,95% CI (1.092-1.297),P < 0.001], while diabetes was negatively correlated with CCC formation [OR = 0.285,95% CI (0.094-0.864), P < 0.05]. Ischemic modified albumin predicted good formation of CCC according to the ROC curve, and the area under the ROC curve was 0.769(95% CI,0.686-0.851, P<0.001); the optimal cut-off value was 63.35 KU/L, and the sensitivity was 71.2%,specificity is 71%.

CONCLUSION

The IMA level is closely related to good formation of CCC. Higher IMA levels can be used as an effective predictor of good CCC formation in patients with CTO.

摘要

目的

探讨缺血修饰白蛋白(IMA)水平与慢性完全闭塞(CTO)患者冠状动脉侧支循环(CCC)的相关性。

方法

2017 年 08 月至 2019 年 02 月,武汉大学中南医院心内科行冠状动脉造影,共筛选出至少一支主要冠状动脉存在 CTO 病变的 128 例患者。根据 Rentrop 评价标准,CCC 形成程度分为 CCC 形成不良组(Rentrop0-1 级,n=69)和 CCC 形成良好组(Rentrop2-3 级,n=59)。采用白蛋白-钴结合法测定患者的 IMA 水平。记录并分析患者的一般资料、血常规、总胆红素(TBIL)、血脂、尿酸(UA)、左心室射血分数(LVEF)等血管闭塞评估指标。

结果

与 CCC 形成良好组相比,CCC 形成不良组血小板计数和糖尿病的比例较高(P<0.05)。CCC 形成不良组的缺血修饰白蛋白与总胆红素比值低于 CCC 形成良好组(P<0.05)。多因素 logistic 回归分析显示,缺血修饰白蛋白与 CCC 形成呈正相关[OR=1.190,95%CI(1.092-1.297),P<0.001],而糖尿病与 CCC 形成呈负相关[OR=0.285,95%CI(0.094-0.864),P<0.05]。根据 ROC 曲线,缺血修饰白蛋白预测 CCC 良好形成,ROC 曲线下面积为 0.769(95%CI,0.686-0.851,P<0.001);最佳截断值为 63.35 KU/L,敏感度为 71.2%,特异度为 71%。

结论

IMA 水平与 CCC 良好形成密切相关。较高的 IMA 水平可作为 CTO 患者 CCC 良好形成的有效预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52f6/7341651/502edda6be38/12872_2020_1543_Fig1_HTML.jpg

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