老年冠心病患者血清生长分化因子11、多配体蛋白聚糖-1表达与冠状动脉狭窄的关系

Relationship between expression of serum growth differentiation factor 11 and syndecan-1 and coronary artery stenosis in eld-erly patients with coronary heart disease

中文关键词: 老年  冠心病  生长分化因子11  多配体蛋白聚糖-1  冠状动脉狭窄

英文关键词: elderly  coronary heart disease  growth differentiation factor 11  syndecan-1  coronary artery stenosis

中文摘要:

      目的 探讨老年冠心病(CHD)患者血清生长分化因子11(GDF11)、多配体蛋白聚糖(SDC)-1表达与冠状动脉狭窄的关系.方法 2022年6月—2025年2月,唐山弘慈医院老年医学科收治的163例老年CHD患者作为研究对象(CHD组),根据Gensini评分评估冠状动脉狭窄程度,将患者分为轻度组(n=98)、中度组(n=41)、重度组(n=24).选取同期85例体检冠状动脉造影结果正常的老年人(年龄≥60岁)作为对照组.检测血清GDF11、SDC-1水平;Spearman等级相关分析血清GDF11、SDC-1与冠状动脉狭窄严重程度的相关性.多因素二元Logistic回归法分析老年CHD患者发生中重度冠状动脉狭窄的影响因素.受试者操作特征曲线评估血清GDF11、SDC-1对老年CHD患者发生中重度冠状动脉狭窄的预测效能.结果 与对照组相比,CHD组血清GDF11水平降低,SDC-1水平升高(P＜0.05).与轻度组相比,中度组、重度组血清GDF11、白细胞计数、三酰甘油、低密度脂蛋白胆固醇(LDL-C)水平及Gensini评分均升高;且重度组SDC-1、LDL-C水平及Gensini评分均高于中度组(P＜0.05).血清GDF11水平与SDC-1、冠状动脉狭窄严重程度呈负相关(P＜0.001),血清SDC-1水平与冠状动脉狭窄严重程度呈正相关(P＜0.001).多因素Logistic回归分析显示,Gensini评分升高、SDC-1水平升高是老年CHD患者发生中重度冠状动脉狭窄的危险因素,GDF11水平升高是老年CHD患者发生中重度冠状动脉狭窄的保护因素(P＜0.05).血清GDF11、SDC-1水平单独及联合预测对老年CHD患者发生中重度冠状动脉狭窄的曲线下面积分别为0.836、0.844、0.923,二者联合预测效能较优(P＜0.05).结论 老年CHD患者血清GDF11水平降低、SDC-1水平升高与冠状动脉狭窄有关,二者联合或可作为预测老年CHD患者中重冠状动脉狭窄的血清指标.

英文摘要:

      Objective To discuss the relationship between the expression of serum growth differentiation factor 11(GDF11)and(SDC)-1 and coronary artery stenosis in elderly patients with coronary heart disease(CHD).Methods From June 2022 to February 2025,163 elderly CHD patients admitted to Department of Geriatrics of Tangshan Hongci Hospital were selected as study subjects(CHD group).The degree of coronary artery stenosis was assessed according to the Gensini score.Based on the degree of coronary artery stenosis,they were divided into mild group(n=98),moderate group(n=41),and severe group(n=24).Another 85 elderly people(aged≥ 60 years)with normal coronary angiography results during physical examination in the same period were selected as control group.The levels of serum GDF11 and SDC-1 were detected.Spearman rank correlation analysis was used to analyze the correlation between the levels of serum GDF11 and SDC-1 and the severity of coronary artery stenosis.Multivariate binary Logistic regression was used to analyze the influencing factors for mod-erate-to-severe coronary artery stenosis in elderly CHD patients.The receiver operating characteristic curve was used to evaluate the predictive efficacy of serum GDF11 and SDC-1 for moderate-to-severe coronary artery stenosis in elderly CHD patients.Results Compared with the control group,the serum GDF11 level in the CHD group decreased and the SDC-1 level increased(P＜0.05).Compared with the mild group,the levels of serum GDF11,white blood cell count,triglycerides,low-density lipoprotein cholesterol(LDL-C),and Gensini score in the moderate group and severe group increased.And the levels of SDC-1 and LDL-C and Gensini score in the severe group were all higher than those in the moderate group(P＜0.05).Serum GDF11 level was negatively correlated with SDC-1 level and coronary stenosis severity(P＜0.001),and serum SDC-1 level was positively correlated with coronary stenosis severity(P＜0.001).Multifactorial Logistic regression analysis showed that elevated Gensini score and elevated SDC-1 were risk factors for moderate-to-severe coronary artery stenosis in elderly CHD pa-tients,while elevated GDF11 was a protective factor for moderate-to-severe coronary artery stenosis(P＜0.05).The area un-der the curves of serum GDF11 and SDC-1 levels alone and in combination for predicting moderate-to-severe coronary artery stenosis in elderly CHD patients were 0.836,0.844 and 0.923,respectively.The combined predictive efficacy of the two was better(P＜0.05).Conclusion Decreased serum GDF11 level and elevated SDC-1 level are associated with coronary artery stenosis in elderly CHD patients,and their combination may be used as a serum predictor for predicting moderate-to-severe cor-onary artery stenosis in elderly CHD patients.