血清γ-谷氨酰转肽酶对稳定性心绞痛患者远期预后影响的临床研究

目的:探讨血清γ-谷氨酰转肽酶（GGT）对稳定性心绞痛患者远期预后的影响。方法:使用2014-2018年在天津市胸科医院心内科登记住院的病例数据资料进行回顾性队列研究，共295例新发稳定性心绞痛患者纳入研究。以患者首次确诊冠心病的日期为观察起点，观察终点为出现终点事件或最后一次就诊日期。根据观察期间是否发生不良心血管事件（MACE）分为事件组和非事件组，并根据GGT四分位数将患者分为4组，使用Cox风险回归模型分析GGT对MACE的影响。结果:本次研究随访中位数为4.06年，共有86例（29.15%）冠心病患者发生MACE事件，事件组患者在入院时年龄、高血压比例、TC、LDL-C、ALT和GGT水平均高于无事件组，差异具有统计学意义（均P＜0.05）；不同冠状动脉病变程度的患者MACE发生率存在差异，且三支病变的患者GGT含量要高于双支病变和单支病变，差异具有统计学意义（P＜0.001）。多因素Cox回归分析显示，GGT（与≤25 U/L组相比，31 U/L＜GGT≤38 U/L和＞38 U/L组的HR分别为1.109、1.299）、年龄（与＜60岁相比，≥60岁的HR=1.683，95%CI:1.394~2.032）、高血压（HR=1.562，95%CI:1.201~2.032）、TC（HR=1.286，95%CI:1.079~1.533）对稳定性心绞痛患者远期发生MACE事件的影响均有统计学意义（P＜0.05）。结论:血清GGT水平升高与稳定性心绞痛患者MACE的发生有关，为进一步临床研究提供了理论依据。

Clinical study on the effect of serum gamma-glutamyl transpeptidase on long-term prognosis of patients with stable coronary artery disease

Objective: To explore the effect of serum gamma-glutamyl transpeptidase(GGT) on the long-term prognosis of patients with stable coronary artery disease. Methods: A retrospective cohort study was conducted by using Tianjin Chest Hospital database during 2014-2018. A total of 295 patients with stable coronary artery disease were enrolled and followed until the earliest of outcome occurrence. Patients were divided into event group and non-event group according to whether adverse cardiovascular events (MACE) occurred during follow-up, and patients were also divided into four groups according to the quartiles of GGT. Cox proportional hazards regression model was used to analyze the effects of GGT on MACE. Results: The median follow-up of this study was 4.06 years, and a total of 86 patients (29.15%) with stable coronary artery disease had MACE events. Patients in the event group had higher levels of age, hypertension, TC, LDL-C, ALT and GGT than those in the non-event group(all P＜0.05). GGT levels of patients with three-vessel disease was higher than that of patients with double-vessel disease and single-vessel disease(all P＜0.001). Cox proportional hazards regression analysis showed that GGT (compared with ≤ 25 U/L group, the HR of 31 U/L < GGT≤38 U/L and > 38 U/L group was 1.109, 1.299, respectively), age (compared with ＜60 years old group, HR = 1.683 in≥60 years old group , 95% CI: 1.394-2.032), hypertension(HR=1.562, 95% CI: 1.201-2.032), TC(HR = 1.286, 95% CI: 1.079-1.533), which had statistical significance on the long-term MACE events in patients with stable coronary artery disease(P < 0.05). Conclusion: The increase of serum GGT level is related to the occurrence of MACE in patients with stable coronary artery disease, which provides a theoretical basis for further clinical studies.