单胺氧化酶在不同年龄ACS患者冠状动脉病变严重程度评估中的价值

doi:10.3969/j.issn.1673-8640.2026.01.006

摘要/Abstract

摘要：

目的探讨单胺氧化酶（MAO）在不同年龄急性冠状动脉综合征（ACS）患者冠状动脉病变严重程度评估中的价值。方法选取2022年1月—2023年8月于川北医学院附属大竹医院行冠状动脉造影检查的ACS患者262例，以同期冠状动脉造影检查结果无异常的患者242例作为对照组。收集所有患者临床资料（年龄、性别、吸烟史、糖尿病史、高血压史、体重指数等）和常规生化指标检测结果，并检测血清MAO水平。将所有患者按年龄分为青年（18岁~<40岁）、中年（40岁~<60岁）、老年（≥60岁）。根据冠状动脉造影检查结果将ACS患者分为单支病变组（80例）、双支病变组（111例）和三支病变组（71例）。采用Gensini评分评估ACS患者冠状动脉的病变程度，按三分位法将所有患者分为低值（<45分）组（84例）、中值（45分~<65分）组（108例）和高值（≥65分）组（70例），将Gensini评分≥45分定义为高Gensini评分（提示冠状动脉病变程度严重）。采用Pearson相关分析评估MAO与其他指标的相关性。采用多因素Logistic回归分析评估MAO与ACS发生风险的关系。采用受试者工作特征（ROC）曲线评价MAO判断不同年龄ACS患者冠状动脉发生严重病变的效能。结果 ACS组MAO水平显著高于对照组（P<0.001）。校正临床资料和常规生化指标后，高水平MAO是ACS发生的独立危险因素[比值比（OR）值为3.60，95%可信区间（CI）为2.27~5.71，P<0.001]。在对照组中，老年患者MAO水平高于中年患者、青年患者（P<0.05），中年患者和青年患者MAO水平差异无统计学意义（P>0.05）。在ACS组中，青年患者、中年患者、老年患者MAO水平依次升高（P<0.001）。单支病变组、双支病变组、三支病变组和Gensini评分低值组、中值组、高值组MAO水平均依次升高（P<0.001），且在各组中青年患者、中年患者、老年患者MAO水平均依次升高（P<0.05）。ACS患者MAO与心肌肌钙蛋白I（cTnI）、高敏C反应蛋白（hs-CRP）、Gensini评分均呈正相关（P<0.05）。血清MAO判断老年患者、中年患者、青年患者冠状动脉发生严重病变的曲线下面积（AUC）分别为0.867、0.843、0.732。结论血清MAO水平与ACS患者冠状动脉病变支数、病变程度密切相关，且呈年龄依赖性升高，其判断中老年ACS患者冠状动脉病变严重程度的效能较高。

关键词: 单胺氧化酶, 急性冠状动脉综合征, 年龄

Abstract:

Objective To investigate the role of monoamine oxidase（MAO）in assessing the severity of coronary artery lesions in patients with acute coronary syndrome（ACS）of different age groups. Methods A total of 262 ACS patients who underwent coronary angiography at Dazhu Hospital Affiliated to North Sichuan Medical College from January 2022 to August 2023 were enrolled. Totally，242 patients with normal coronary angiography results were used as control group. The clinical data（age，gender，smoking history，diabetes mellitus history，hypertension history，body mass index and so on）and routine biochemical determination results were collected. Serum MAO levels were also determined. All the patients were classified by age into young（18 years old to < 40 years old），middle-aged（40 years old to < 60 years old）and elderly（≥60 years old）groups. ACS patients were classified into single-vessel lesion group（80 cases），double-vessel lesion group（111 cases）and triple-vessel lesion group（71 cases）according to the results of coronary angiography. The severity of coronary artery lesions in ACS patients was evaluated using the Gensini score，and they were classified into low value（< 45 points）group（84 cases），medium value（45 points to < 65 points）group（108 cases）and high value（≥65 points）group（70 cases） according to the tertile method. A high Gensini score（indicating severe coronary artery lesions）was defined as Gensini score ≥45 points. Pearson correlation analysis was used to evaluate the correlation between MAO and other indicators. Multivariate Logistic regression analysis was used to evaluate the relationship between MAO and the risk of ACS occurrence. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of MAO in determining the occurrence of severe coronary artery lesions in ACS patients of different age groups. Results The MAO level in ACS group was higher than that in control group（P<0.001）. After adjusting for clinical data and routine biochemical indicators，high-level MAO was an independent risk factor for ACS occurrence [odds ratio（OR）=3.60，95% confidence interval（CI）2.27-5.71，P<0.001]. In control group，the MAO level of elderly patients was higher than that of middle-aged and young patients（P<0.05），and there was no statistical significance in the MAO levels between middle-aged and young patients（P>0.05）. In ACS group，the MAO levels of young，middle-aged and elderly patients were increased successively（P<0.001）. The MAO levels were increased successively among single-vessel group，double-vessel group，triple-vessel group and among low value，medium value and high value groups of Gensini score（P<0.001），and among all the groups，the MAO levels of young，middle-aged and elderly patients were increased successively（P<0.05）. MAO in ACS patients was positively correlated with cardiac troponin I（cTnI），high-sensitivity C-reactive protein（hs-CRP）and Gensini score（P<0.05）. The areas under curves（AUC）of serum MAO for diagnosing severe coronary artery lesions in elderly，middle-aged and young ACS patients were 0.867，0.843 and 0.732，respectively. Conclusions Serum MAO levels are related to the lesion vessel number and severity of coronary artery lesions in ACS patients and increase age-dependently. Its efficacy in determining the severity of coronary artery lesions in middle-aged and elderly ACS patients is higher.

Key words: Monoamine oxidase, Acute coronary syndrome, Age

中图分类号:

Q554

田祥全, 范忠才. 单胺氧化酶在不同年龄ACS患者冠状动脉病变严重程度评估中的价值[J]. 检验医学, 2026, 41(1): 34-40.

TIAN Xiangquan, FAN Zhongcai. Role of monoamine oxidase in assessing the severity of coronary artery lesions in ACS patients of different ages[J]. Laboratory Medicine, 2026, 41(1): 34-40.

图/表 11

参考文献 25

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组别	例数	年龄/岁	性别		吸烟史/ [例（%）]	糖尿病史/ [例（%）]	高血压史/ [例（%）]	体重指数/ （kg·m-2）
组别	例数	年龄/岁	男/[例（%）]	女/[例（%）]	吸烟史/ [例（%）]	糖尿病史/ [例（%）]	高血压史/ [例（%）]	体重指数/ （kg·m-2）
对照组	242	57.46±15.27	126（52.07）	116（47.93）	118（48.76）	125（51.65）	109（45.04）	23.76±3.52
ACS组	262	55.28±14.21	116（44.27）	146（55.73）	129（49.24）	153（58.40）	135（51.53）	24.35±3.24
统计值		1.660	1.749		0.011	2.313	2.119	1.959
P值		0.097	0.080		0.914	0.128	0.145	0.051

组别	例数	年龄/岁	性别		吸烟史/ [例（%）]	糖尿病史/ [例（%）]	高血压史/ [例（%）]	体重指数/ （kg·m-2）
组别	例数	年龄/岁	男/[例（%）]	女/[例（%）]	吸烟史/ [例（%）]	糖尿病史/ [例（%）]	高血压史/ [例（%）]	体重指数/ （kg·m-2）
对照组	242	57.46±15.27	126（52.07）	116（47.93）	118（48.76）	125（51.65）	109（45.04）	23.76±3.52
ACS组	262	55.28±14.21	116（44.27）	146（55.73）	129（49.24）	153（58.40）	135（51.53）	24.35±3.24
统计值		1.660	1.749		0.011	2.313	2.119	1.959
P值		0.097	0.080		0.914	0.128	0.145	0.051

组别	例数	HDL-C/（mmol·L^-1）		LDL-C/（mmol·L^-1）		TG/（mmol·L^-1）		TC/（mmol·L^-1）	MAO/（U·L^-1）
对照组	242	1.27±0.29		2.45±0.46		2.19±0.62		3.46±0.78	1.86±0.42
ACS组	262	1.31±0.36		2.57±0.61		2.26±0.71		3.65±0.89	3.82±0.88
统计值		1.367		2.478		1.175		2.540	31.490
P值		0.172		0.014		0.241		0.011	<0.001
组别	cTnI/（μg·L^-1）		hs-CRP/（mg·L^-1）		FBG/（mmol·L^-1）		NT-proBNP/（ng·L^-1）
对照组	0.46±0.08		3.69±0.84		6.48±1.74		424.12（327.54，456.84）
ACS组	1.95±0.71		9.41±1.67		6.96±1.82		1 085.72（887.02，1 231.77）
统计值	32.450		47.970		3.021		-18.931
P值	<0.001		<0.001		0.003		<0.001

组别	例数	HDL-C/（mmol·L^-1）		LDL-C/（mmol·L^-1）		TG/（mmol·L^-1）		TC/（mmol·L^-1）	MAO/（U·L^-1）
对照组	242	1.27±0.29		2.45±0.46		2.19±0.62		3.46±0.78	1.86±0.42
ACS组	262	1.31±0.36		2.57±0.61		2.26±0.71		3.65±0.89	3.82±0.88
统计值		1.367		2.478		1.175		2.540	31.490
P值		0.172		0.014		0.241		0.011	<0.001
组别	cTnI/（μg·L^-1）		hs-CRP/（mg·L^-1）		FBG/（mmol·L^-1）		NT-proBNP/（ng·L^-1）
对照组	0.46±0.08		3.69±0.84		6.48±1.74		424.12（327.54，456.84）
ACS组	1.95±0.71		9.41±1.67		6.96±1.82		1 085.72（887.02，1 231.77）
统计值	32.450		47.970		3.021		-18.931
P值	<0.001		<0.001		0.003		<0.001

组别	例数	MAO/（U·L^-1）
对照组
男	126	1.68±0.43
女	116	1.72±0.41
t值		0.739
P值		0.461
ACS组
男	116	3.98±0.87
女	146	4.14±0.91
t值		1.441
P值		0.151