2023 年第 4 期 第 18 卷

血清γ-谷氨酰转肽酶联合心外膜脂肪组织体积对高血压患者并发冠状动脉钙化的诊断价值

Diagnostic value of serum γ-glutamyl transpeptidase combined with epicardial adipose tissue volume in hypertensive patients with coronary artery calcification

作者：倪萍夏梦怡吕晓蕾

英文作者：Ni Ping Xia Mengyi Lyu Xiaolei

单位：江苏省昆山市第一人民医院心血管内科，昆山215300

英文单位：Department of Cardiovascular Medicine the First People′s Hospital of Kunshan Jiangsu Province Kunshan 215300 China

关键词：高血压；冠状动脉钙化；γ-谷氨酰转肽酶；心外膜脂肪组织体积

英文关键词：Hypertension;Coronaryarterycalcification;γ-glutamyltranspeptidase;Epicardialadiposetissuevolume

• 摘要：

• 目的 探讨血清γ-谷氨酰转肽酶（γ-GT）联合心外膜脂肪组织体积（EATV）对高血压患者并发冠状动脉钙化（CAC）的诊断价值。方法 选取2020年1月至2022年3月江苏省昆山市第一人民医院收治的129例高血压患者（高血压组），根据是否并发CAC分为CAC组（67例）和非CAC组（62例），另选取同期51名体检健康者为对照组。采用比色法检测血清γ-GT水平，CT测量EATV。通过多因素Logistic回归方法分析高血压患者并发CAC的影响因素，受试者工作特征曲线分析血清γ-GT、EATV及二者联合对高血压患者并发CAC的诊断价值。结果 高血压组血清γ-GT水平和EATV高于对照组［（72±13）U/L比（25±5）U/L、111.20（87.00,136.69）mm3比42.43（36.09,50.38）mm3］（均P＜0.001）。CAC组血清γ-GT水平和EATV高于非CAC组（均P＜0.001）。多因素Logistic回归分析显示，年龄增加、病程延长、血尿酸升高、γ-GT升高、EATV增加为高血压患者并发CAC的独立危险因素（均P＜0.05）。受试者工作特征曲线分析显示，血清γ-GT水平和EATV单独与联合诊断高血压患者并发CAC的曲线下面积分别为0.793、0.805、0.880，敏感度分别为80.60%、59.70%、70.15%，特异度分别为62.90%、90.32%、91.94%。结论 血清γ-GT水平和EATV升高与高血压患者并发CAC密切相关，可作为高血压患者并发CAC的辅助诊断指标，且血清γ-GT联合EATV对高血压患者并发CAC的辅助诊断价值较高。

• Objective To investigate the diagnostic value of serum γ-glutamyl transpeptidase (γ-GT) combined with epicardial adipose tissue volume (EATV) in hypertensive patients with coronary artery calcification (CAC). Methods From January 2020 to March 2022, 129 hypertensive patients(hypertension group) admitted to the First People′s Hospital of Kunshan, Jiangsu Province were selected. They were divided into the CAC group (67 cases) and the non-CAC group (62 cases) according to whether they had CAC. Another 51 physically healthy people were selected during the same period as control group. Serum γ-GT level was measured by colorimetric method and EATV was measured by CT. Multivariate Logistic regression was used to analyze the influencing factors of concurrent CAC in hypertensive patients and the diagnostic value of serum γ-GT, EATV and their combination for concurrent CAC in hypertensive patients was analyzed by receiver operating characteristic curve. Results Serum γ-GT level and EATV in the hypertensive group were higher than those in the control group［（72±13）U/L vs （25±5）U/L, 111.20（87.00,136.69）mm3 vs 42.43（36.09,50.38）mm3］(both P＜0.001). Serum γ-GT level and EATV in the CAC group were higher than those in the non-CAC group (both P＜0.001). Multivariate Logistic regression analysis showed that increasing age, prolonged disease duration, elevated blood uric acid, elevated γ-GT, and increased EATV were independent risk factors for concurrent CAC in hypertensive patients (all P＜0.05). The receiver operating characteristic curve showed that the areas under the curve of serum γ-GT level and EATV alone and in combination for the diagnosis of concurrent CAC in hypertensive patients was 0.793, 0.805 and 0.880, respectively, with sensitivities of 80.60%, 59.70% and 70.15% and specificities of 62.90%, 90.32% and 91.94%, respectively. Conclusions  Elevated serum γ-GT level and EATV are closely associated with concurrent CAC in hypertensive patients, and can be used as auxiliary diagnostic indexes for concurrent CAC in hypertensive patients. Serum γ-GT combined with EATV has high value in the auxiliary diagnosis of concurrent CAC in hypertensive patients.