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冠心病患者血清环磷酸腺苷反应元件结合蛋白调节转录辅激活因子3及氧化应激指标与颈动脉粥样硬化的相关性

Correlations of serum cyclic adenosine monophosphate-responsive element binding protein regulator of transcription coactivator 3 and oxidative stress indicators with carotid atherosclerosis in patients with coronary heart disease

    摘要
  • 摘要:
    目的  探讨冠心病患者血清环磷酸腺苷反应元件结合蛋白调节转录辅激活因子3(CRTC3)及氧化应激指标与颈动脉粥样硬化的相关性。
    方法  选取2021年6月—2023年6月本院收治的154例冠心病患者为研究组, 根据颈动脉粥样硬化程度分为轻度硬化组、中度硬化组和重度硬化组; 另选取154例同期健康体检者为对照组。采用Pearson法分析血清CRTC3及氧化应激指标与颈动脉粥样硬化指标的相关性。
    结果  研究组血清CRTC3、丙二醛(MDA)、颈动脉斑块面积和中层内膜厚度(IMT)高于或大于对照组，超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平低于对照组，差异有统计学意义(P < 0.05)。轻度硬化组、中度硬化组和重度硬化组血清CRTC3、MDA、颈动脉斑块面积和IMT依次升高或增大, SOD、GSH-Px水平依次降低，差异有统计学意义(P < 0.05)。Pearson相关性分析显示，血清CRTC3、MDA水平与颈动脉斑块面积、IMT呈正相关(P < 0.05), SOD、GSH-Px与颈动脉斑块面积、IMT呈负相关(P < 0.05)。受试者工作特征(ROC)曲线显示, CRTC3、SOD、MDA和GSH-Px联合诊断重度颈动脉粥样硬化的曲线下面积(AUC)为0.990(95%CI: 0.982~0.998), 灵敏度为96.27%, 特异度为76.28%。4项指标联合诊断的价值高于各指标单独诊断，差异有统计学意义(Z联合-CRTC3=2.723, Z联合-SOD=2.698, Z联合-MDA=2.673, Z联合-GSH-Px=2.803, P均 < 0.05)。
    结论  冠心病患者血清CRTC3、MDA水平显著升高，SOD、GSH-Px水平显著降低; 血清CRTC3、氧化应激水平均与颈动脉粥样硬化密切相关。

     

    Abstract:
    Objective  To investigate the correlations of serum cyclic adenosine monophosphate-responsive element binding protein regulator of transcription coactivator 3 (CRTC3) and oxidative stress indicators with carotid atherosclerosis in patients with coronary heart disease (CHD).
    Methods  A total of 154 CHD patients in the hospital from June 2021 to June 2023 were selected as study group and divided into mild, moderate, and severe atherosclerosis groups based on the degree of carotid atherosclerosis; another 154 healthy individuals with physical examinations in the same period were selected as control group. Pearson method was used to analyze the correlations of serum CRTC3 and oxidative stress indicators with carotid atherosclerosis indicators.
    Results  Serum CRTC3 and malondialdehyde (MDA), carotid plaque area and intima-media thickness (IMT) in the study group were significantly higher than those in the control group, while the levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were significantly lower than those in the control group (P < 0.05). In the mild, moderate and severe atherosclerosis groups, serum CRTC3 and MDA levels, carotid plaque area, and IMT significantly gradually increased, while SOD and GSH-Px levels significantly gradually decreased (P < 0.05). Pearson correlation analysis showed that serum CRTC3 and MDA levels were positively correlated with carotid plaque area and IMT (P < 0.05), while SOD and GSH-Px were negatively correlated with carotid plaque area and IMT (P < 0.05). The receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for the combined diagnosis of severe carotid atherosclerosis by CRTC3, SOD, MDA and GSH-Px was 0.990 (95%CI, 0.982 to 0.998), with a sensitivity of 96.27% and a specificity of 76.28%. The diagnostic value of the combined application of these four indicators was significantly higher than that of each indicator alone (Zcombined-CRTC3=2.723, Zcombined-SOD=2.698, Zcombined-MDA=2.673, Zcombined-GSH-Px=2.803, P < 0.05).
    Conclusion  The serum levels of CRTC3 and MDA are significantly increased while SOD and GSH-Px levels are significantly decreased in CHD patients. Both serum CRTC3 and oxidative stress levels are closely related to carotid atherosclerosis.

     

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