血清内脏脂肪素水平与冠心病患者氧化应激、颈动脉粥样硬化的相关性及通心络胶囊的干预作用

摘要

目的 探讨血清内脏脂肪素(visfatin)水平与冠心病患者氧化应激、颈动脉粥样硬化的相关性及通心络胶囊的干预作用.方法 选取2010年9月—2012年10月南京医科大学第一附属医院收治的冠心病患者100例作为病例组,按照入院顺序分为对照组和干预组,每组50例;选取同期体检健康者50例作为健康组.对照组患者给予常规治疗,干预组患者在常规治疗基础上给予通心络胶囊治疗,连续治疗12个月.比较健康组与病例组受试者血清visfatin、丙二醛(MDA)、超氧化物歧化酶(SOD)水平,颈动脉内-中膜厚度(IMT)、斑块面积,血清visfatin水平与血清MDA、SOD水平及颈动脉IMT、斑块面积间的相关性分析采用Pearson相关分析;比较对照组与干预组患者治疗前后血清visfatin、MDA、SOD水平,颈动脉IMT、斑块面积,并观察两组患者治疗期间不良反应发生情况.结果 病例组患者血清visfatin、MDA水平高于健康组,血清SOD水平低于健康组,颈动脉IMT、斑块面积大于健康组(P<0.05).Pearson相关分析结果显示,血清visfatin水平与冠心病患者血清MDA水平(r=0.486)及颈动脉IMT(r=0.388)、斑块面积(r=0.354)呈正相关,与血清SOD水平(r=-0.343)呈负相关(P<0.05).治疗前对照组与干预组患者血清visfatin、MDA、SOD水平及颈动脉IMT、斑块面积比较,差异无统计学意义(P>0.05);治疗后干预组患者血清visfatin、MDA水平低于对照组,血清SOD水平高于对照组,颈动脉IMT、斑块面积小于对照组(P<0.05).治疗期间对照组、干预组患者均未出现过敏、肝肾功能损伤等不良反应.结论 冠心病患者血清visfatin水平明显升高,并与氧化应激、颈动脉粥样硬化有关;通心络胶囊可通过降低血清visfatin水平而抑制冠心病患者氧化应激反应,发挥抗动脉粥样硬化作用,且安全性较高.%Objective To investigate the correlations of serum visfatin level with oxidative stress and carotid atherosclerosis in patients with coronary heart disease and the interventional effect of Tongxinluo capsule.Methods A total of 100 patients with coronary heart disease were selected as case group in the First Affiliated Hospital of Nanjing Medical Universityfrom September 2010 to October 2012,and they were divided into control group and intervention group according to visiting sequence,each of 50 cases;meanwhile a total of 50 healthy volunteers were selected as healthy control group. Patients in control group received conventional treatment,while patients in intervention group received Tongxinluo capsule for 12 months based on that of control group. Serum levels of visfatin,MDA and SOD,carotid IMT and plaque area were compared between healthy control group and case group,and correlations of serum visfatin level with serum levels of MDA and SOD,carotid IMT and plaque area were analyzed by Pearson correlation analysis;serum levels of visfatin,MDA and SOD,carotid IMT and plaque area were compared between control group and intervention group before and after treatment,and incidence of adverse reactions was observed during treatment.Results Serum levels of visfatin and MDA in case group were statistically significantly higher than those in healthy control group,while serum SOD level in case group was statistically significantly lower than that in healthy control group,carotid IMT and plaque area in case group were statistically significantly lager than those in healthy control group(P<0.05). Pearson correlation analysis results showed that,serum visfatin level was positively correlated with serum MDA level(r=0.486),carotid IMT(r=0.388)and carotid plaque area(r=0.354)in patients with coronary heart disease, respectively,was negatively correlated with serum SOD level(r=-0.343)(P<0.05). No statistically significant differences of serum level of visfatin,MDA or SOD,carotid IMT or plaque area was found between control group and intervention group before treatment(P>0.05);after treatment,serum levels of visfatin and MDA in intervention group were statistically significantly lower than those in control group,while serum SOD level in intervention group was statistically significantly higher than that in control group,carotid IMT and plaque area in intervention group were statistically significantly smaller than those in control group(P<0.05). No one in control group or intervention group occurred adverse reactions such as anaphylaxis,liver or kidney function injury.Conclusion Serum visfatin level is significantly elevated in patients with coronary heart disease,and it is correlated with oxidative stress and carotid atherosclerosis;Tongxinluo capsule may inhibit the oxidative stress and carotid atherosclerosis by reducing serum visfatin level in patients with coronary heart disease,with relatively high safety.