冠状动脉造影正常胸痛患者谷氨酰转肽酶表达水平 及与冠状动脉微循环阻力指数的相关性

GGT expression level in chest pain patients with normal coronary angiography and its correlation with IMR

摘要:

目的 探讨冠状动脉造影（CAG）正常的胸痛患者谷氨酰转肽酶表达水平及其与冠状动脉微循 环阻力指数（IMR）的相关性。方法 选取2018 年6 月—2019 年6 月在青海省心脑血管病专科医院就诊的 103 例患者作为研究对象。收集并比较患者一般资料，以测得冠状动脉前降支IMR 中位数（22.32）作为分 组依据，将患者分为IMR 正常组（IMR<22.32）58 例和IMR 升高组（IMR ≥ 22.32）45 例。检测并比较患 者血清生物化学指标，并与IMR 进行相关性分析，对IMR 值影响因素进行多元线性回归分析。结果 IMR 升高组患者糖尿病史及高血压史比例高于IMR 正常组（P <0.05）。IMR 升高组患者血清谷氨酰转肽酶水平、 IMR 高于IMR 正常组，而HDL 低于IMR 正常组（P <0.05）。IMR 与谷氨酰转肽酶水平呈正相关（r =0.413， P =0.000），而与HDL 水平呈负相关（r =-0.326，P =0.028）；血清谷氨酰转肽酶水平[b =0.248（95% CI ： 0.042，0.871），P =0.031] 是IMR 的独立影响因素（P <0.05）。结论 CAG 正常的胸痛患者血清谷氨酰转肽 酶有一定程度上升，血清谷氨酰转肽酶高水平表达可能参与CAG 正常的胸痛患者冠状动脉微循环障碍，导致 IMR 升高。

Abstract:

Objective To investigate the glutamyltransferase (GGT) expression level in chest pain patients with normal coronary angiography (CAG) and its correlation with index of microcirculatory resistance (IMR). Methods From June 2018 to June 2019, 103 patients with highly suspected coronary heart disease admitted to our hospital were selected and divided into two groups based on the median IMR of the anterior descending coronary artery (22.32U), such as normal IMR group (n = 58) and elevated IMR group (n = 45). The levels of biochemical indexes in patients’ serum were measured and compared, the correlation analysis between the measured biochemical indexes and IMR was carried out, and multiple linear regression analysis was carried out on the influencing factors of IMR value. Results The proportion of patients with history of diabetes and hypertension in the elevated IMR group was significantly higher than that in the normal IMR group (P < 0.05). The elevated IMR group had higher GGT level and IMR value as well as lower HDL level than the normal IMR group, with statistic differences (P < 0.05). IMR was positively correlated with serum GGT (r = 0.413, P < 0.05) and negatively correlated with HDL (r = -0.326, P < 0.05). Serum GGT level was an independent correlation factor of IMR value [b = 0.248 (95% CI: 0.042, 0.871), P < 0.05]. Conclusions Serum GGT level is elevated in chest pain patients with normal CAG, and its elevation may participate the coronary microvascular dysfunction, which leads to the increase of IMR value.