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联合检测血清 C1q 和 hsCRP 在预测冠状动脉疾病中的临床作用。

The clinical role of combined serum C1q and hsCRP in predicting coronary artery disease.

机构信息

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

出版信息

Clin Biochem. 2021 Jul;93:50-58. doi: 10.1016/j.clinbiochem.2021.04.004. Epub 2021 Apr 13.

Abstract

OBJECTIVE

C1q has been shown to be associated with coronary heart disease (CAD) and can co-deposit with C-reactive protein (CRP) in atherosclerotic plaques. However, few studies have been conducted between C1q, CRP parameters and CAD. The aim of this study is to explore the relationship between C1q and CRP parameters and assess their clinical significance in CAD.

METHODS

238 total patients who underwent coronary artery angiography were enrolled and divided into control group (n = 65), stable CAD group (n = 47) and unstable angina group (UA group, n = 126). Patients' data were collected from self-administered questionnaires and electrical medical records. The severity of coronary stenosis was presented by Gensini score. The relationship between C1q, CRP parameters and CAD were evaluated by multivariate regression analysis and their predicting performance were assessed by ROC analysis and odds ratio analysis.

RESULTS

Compared with control group, C1q was showed significantly lower in stable CAD (P = 0.004) and UA groups (P = 0.008), while hsCRP was higher in UA group (P = 0.024). Serum C1q was weakly positively associated with hsCRP (r = 0.24, P < 0.001) but not correlated with Gensini score. Logistic regression identified C1q (OR: 0.87 per 10 mg/L, 95% CI: 0.79-0.95, P = 0.001) and hsCRP (OR: 1.08 mg/L, 95% CI: 1.01-1.15, P = 0.032) as independent determinants of CAD. Furthermore, combined C1q and hsCRP level showed higher discriminatory accuracy in predicting CAD than C1q (AUC: 0.676 vs 0.585, P = 0.101; NRI: 10.4%, P = 0.049; IDI: 3.9%, P < 0.001) or hsCRP (AUC: 0.676 vs 0.585, P = 0.101; NRI: 16.7%, P = 0.006; IDI: 5.8%, P < 0.001).

CONCLUSIONS

Reduced serum C1q and increased hsCRP are independently associated with CAD and could be potential predictors for CAD diagnosis. Furthermore, combined C1q and hsCRP showed better performance in predicting CAD than using single one.

摘要

目的

C1q 已被证明与冠心病(CAD)相关,并可与动脉粥样硬化斑块中的 C-反应蛋白(CRP)共同沉积。然而,很少有研究探讨 C1q、CRP 参数与 CAD 之间的关系。本研究旨在探讨 C1q 与 CRP 参数之间的关系,并评估其在 CAD 中的临床意义。

方法

共纳入 238 例行冠状动脉造影术的患者,分为对照组(n=65)、稳定型 CAD 组(n=47)和不稳定型心绞痛组(UA 组,n=126)。从自行填写的问卷和电子病历中收集患者数据。采用 Gensini 评分表示冠状动脉狭窄严重程度。采用多元回归分析评估 C1q、CRP 参数与 CAD 的关系,并采用 ROC 分析和优势比分析评估其预测性能。

结果

与对照组相比,稳定型 CAD 组(P=0.004)和 UA 组(P=0.008)的 C1q 水平明显降低,UA 组的 hsCRP 水平较高(P=0.024)。血清 C1q 与 hsCRP 呈弱正相关(r=0.24,P<0.001),但与 Gensini 评分无相关性。Logistic 回归分析发现,C1q(每增加 10mg/L,OR:0.87,95%CI:0.79-0.95,P=0.001)和 hsCRP(OR:1.08mg/L,95%CI:1.01-1.15,P=0.032)是 CAD 的独立决定因素。此外,C1q 和 hsCRP 联合水平在预测 CAD 方面的诊断准确性高于 C1q(AUC:0.676 与 0.585,P=0.101;NRI:10.4%,P=0.049;IDI:3.9%,P<0.001)或 hsCRP(AUC:0.676 与 0.585,P=0.101;NRI:16.7%,P=0.006;IDI:5.8%,P<0.001)。

结论

血清 C1q 降低和 hsCRP 升高与 CAD 独立相关,可能是 CAD 诊断的潜在预测因子。此外,C1q 和 hsCRP 联合检测在预测 CAD 方面的性能优于单一检测。

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