冠心病患者血清脂肪因子和超敏C反应蛋白水平与冠状动脉病变程度相关性研究

摘要

目的:探讨冠心病患者血清脂肪因子(Chemerin)和超敏C反应蛋白(hs-CRP)水平与冠状动脉病变程度的关系.方法:190例冠心病患者根据冠脉造影结果分为对照组(冠脉狭窄<50%, n=40)和冠心病组(至少一支冠脉狭窄冠脉狭窄<50%, n=150).根据狭窄支数将冠心病组分为1支病变组(n=55)、2支病变组(n=60)和多支病变组(n=35);同时根据Gensini积分又将冠心病组分为≤30分组(n=50), 31-59分组(n=68)和≥60分组(n=32).采用ELISA测定各组血清Chemerin水平,采用乳胶增强散射免疫比浊法测定各组hs-CRP水平.比较对照组与冠心病组血清Chemerin、hs-CRP水平差异;分析不同狭窄冠脉支数及不同Gensini积分冠心病患者Chemerin及hs-CRP水平差异及相关性,比较Chemerin水平与hs-CRP水平的相关性及诊断冠心病的优势.结果:(1)冠心病组患者血清Chemerin和hs-CRP水平显著高于对照组(P<0.01).(2)1支病变组、2支病变组和多支病变组冠心病患者血清Chemerin及hs-CRP水平顺序升高(P<0.05),且呈正相关(r=0.716、0.906,P<0.01).(3)不同Gensini积分冠心病患者血清Chemerin及hs-CRP水平依次升高,且积分越高狭窄支数越多,Chemerin及hs-CRP水平越高,且呈正相关(r=0.527、0.667,P<0.01).(4)经Pearson分析显示,hs-CRP和Chemerin水平呈显著正相关, Logistic回归表明hs-CRP与Chemerin同为冠脉病变的危险因素.且hs-CRP诊断冠心病的作用更强(优势比为7.01).结论:Chemerin可能参与冠心病的发生发展,可作为反映冠状动脉病变程度的有效指标,但与hs-CRP的病理作用比较并无优势.%Objective: To explore the correlation between the concentration of serum chemerin,hs-CRP and severity of coronary artery lesions in patients with coronary heart diseases.Method: After rigorous screening,a total of 190 patients were recruited to the study including coronary heart diseases (CHD) group (150 cases) and control group (40 cases).According to the results of coronary angiography, CHD group was subdivided into one-vessel group (55 cases), two-vessels group (60 cases), multi-vessels group (35 cases).According to the Gensini scores CHD group was divided into gorps of ≤30 scores,31-59 scores and ≥60 scores.The levels of serum Chemerin,hs-CRP were measured by ELISA.The serum chemerin,hs-CRP level and the correlation of different coronary artery strictures and Gensini score of coronary stenosis were analyzed.Results:(1) Compared with the control, the concentration of Chemerin,hs-CRP CHD was significantly higher (P<0.01).(2) The level of Chemerin,hs-CRP increased significantly with involved number of vessels and Gensini score(P<0.05).(3) There was a positive correlation between the levels of Chemerin,hs-CRP and number of coronary lesions(r=0.716,r=0.906,P<0.01)or Gensini score(r=0.527,r=0.667,P<0.01).(4) Chemerin and hs-CRP were strong risk factors to coronary artery lesion by Logistic regression analysis.And the level of Chemerin was positively correlated with the concentration of hs-CRP.Conclusion:Chemerin involved the pathophysiological process of coronary heart diseases and could be used as a reflector of severity of coronary artery lesions.