2021 年第 3 期 第 16 卷

血浆Elabela水平对冠心病患者冠状动脉狭窄程度的预测价值

The predictive value of plasma Elabela level for the severity of coronary artery stenosis in patients with coronary atherosclerotic heart disease

作者：冯健张煜李坚王冬雪

英文作者：Feng Jian Zhang Yu Li Jian Wang Dongxue

单位：南京医科大学附属无锡人民医院心血管内科214073

英文单位：

关键词：冠心病（冠状动脉粥样硬化性心脏病）；冠状动脉狭窄；Elabela；预测价值

英文关键词：Coronaryatheroscleroticheartdisease;Coronaryarterystenosis;Elabela;Predictivevalue

• 摘要：

• 目的 探讨血浆Elabela水平对冠心病（冠状动脉粥样硬化性心脏病）患者冠状动脉狭窄程度的预测价值。方法选取2017年1月至2020年1月于南京医科大学附属无锡人民医院接受治疗的冠心病患者80例作为冠心病组，所有冠心病患者均接受冠状动脉造影检查，根据冠状动脉狭窄程度分为重度狭窄组（45例）以及轻度狭窄组（35例）。另选取同期在本院体检的健康志愿者40例作为对照组。收集所有研究对象的一般资料，彩色多普勒超声测量左心室舒张末期内径（LVEDD）、左心室射血分数（LVEF），采用酶联免疫吸附试验法检测血浆N末端B型脑钠肽前体（NT-proBNP）和Elabela水平。采用受试者工作特征（ROC）曲线分析血浆Elabela水平对冠状动脉狭窄程度的预测价值。结果 冠心病组的LVEDD、NT-proBNP、Elabela水平均高于对照组［（53.2±1.2）mm比（50.4±1.3）mm、（1 036±337）ng/L比（129±30）ng/L、（4.3±2.1）μg/L比（2.1±1.0）μg/L］，LVEF水平低于对照组［（50±9）%比（62±5）%］（均P＜0.05）。重度狭窄组的LVEDD、NT-proBNP、Elabela水平均高于轻度狭窄组，差异均有统计学意义（均P＜0.05）。ROC曲线分析显示，冠心病患者血浆Elabela对冠状动脉狭窄程度的预测价值较高，曲线下面积为0.931（95%置信区间：0.874～0.988），敏感度、特异度和约登指数分别为0.867、0.762和0.629。结论 Elabela在冠心病患者血浆中的表达水平异常升高，且其表达与冠状动脉狭窄程度有一定的相关性，血浆Elabela对冠状动脉狭窄程度的预测价值较高。

• Objective To investigate the predictive value of plasma Elabela level for the severity of coronary artery stenosis in patients with coronary heart disease(coronary atherosclerotic heart disease). Methods Eighty patients with coronary heart disease admitted to Wuxi People′s Hospital Affiliated to Nanjing Medical University from January 2017 to January 2020 were selected as the coronary heart disease group. All patients with coronary heart disease received coronary angiography. According to the degree of coronary artery stenosis, they were divided into severe stenosis group(45 cases) and mild stenosis group(35 cases). In addition, 40 healthy volunteers who received physical examination in our hospital during the same period were selected as the control group. The general data of all subjects were collected. Left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were measured by color Doppler ultrasound. Enzyme linked immunosorbent assay was used to detect the levels of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and Elabela. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of plasma Elabela level in the severity of coronary artery stenosis. Results The levels of LVEDD, NT-proBNP and Elabela in the coronary heart disease group were higher than those in the control group［（53.2±1.2）mm vs （50.4±1.3）mm,（1 036±337）ng/L vs （129±30）ng/L,（4.3±2.1）μg/L vs （2.1±1.0）μg/L］， and the LVEF level in the coronary heart disease group was lower than that in the control group［（50±9）% vs （62±5）%］(all P＜0.05). The levels of LVEDD, NT-proBNP and Elabela in severe stenosis group were higher than those in mild stenosis group(all P＜0.05). ROC curve analysis showed that plasma Elabela had high predictive value for degree of coronary artery stenosis. The area under the curve was 0.931 (95% confidence interval: 0.874-0.988), and the sensitivity, specificity and Youden′s index were 0.867, 0.762 and 0.629, respectively. Conclusions The expression level of Elabela in plasma of patients with coronary heart disease is abnormally increased, and its expression has a certain correlation with the degree of coronary artery stenosis. Plasma Elabela has a high predictive value for the degree of coronary artery stenosis.