冠心病患者体内前蛋白转化酶枯草溶菌素9水平与炎性因子的相关性分析

摘要

目的:探讨冠状动脉粥样硬化性心脏病(CAD)患者血浆前蛋白转化酶枯草溶菌素9(PC-SK9)与血脂各指标及性因子的相关性.方法:入选210例未行降脂治疗的胸痛患者,入院后根据冠状动脉造影检查结果分为冠心病组120例和对照组(非冠心病)90例.收集临床资料,采集空腹静脉血检测血常规、血生化等各项指标.采用酶联免疫吸附实验(ELISA)检测患者血浆PCSK9、白介素10(IL-10)水平.结果:两组资料对比,CAD组吸烟及糖尿病史的比例高于对照组,空腹血糖、LDL-C、IL-10、PCSK9水平明显高于对照组,HDL-C水平低于对照组,差异有统计学意义.Logistic回归分析显示在调整了性别、高血压、TG、TC、载脂蛋白A1(ApoA1)、ApoB因素后,老年、吸烟、糖尿病史、LDL-C、脂蛋白(a)、HDL、PCSK9是CAD的独立危险因素.PCSK9与LDL-C、ApoB水平呈正相关;与炎性标志物hs-CRP、中性粒细胞和IL-10呈正相关.结论:PCSK9是CAD的独立危险因素,与动脉粥样硬化(As)的形成和发展有密切关系.PCSK9水平与抗炎细胞因子IL-10及hs-CRP正相关,提示IL-10和hs-CRP与PCSK9共同参与了AS的形成和发展.%Objective:To examine the association of blood lipids,indexes of inflammatory factor with plasma PCSK9 levels in patients with coronary artery disease (CAD).Methods:A total of 210 patients with suspected chest pain had been examined by coronary artery angiography after admission,and was divided into CAD group (patients with coronary stenosis ≥50％ at angiography) and control group (patients with normal coronary artery or coronary stenosis ＜50％ at angiography).All of these patients had no prescription of lipidlowering medications previously.The baseline clinical data were examined,including blood routine,blood biochemical examination,and the plasma levels of PCSK9,IL-10.Results:Compared with control group,the percentage of history of diabetes and smoking was statistically higher in CAD group.The fasting blood-glucose,LDL-C and the plasma PCSK9 were higher in CAD group than in control with statistically significance.After adjusted for gender,age,and hypertension,TG,TC,ApoA1 and ApoB,PCSK9 is an independent risk factor of CAD.Linear regression analysis showed that the plasma PCSK9 levels were significantly correlated with serum lipids,with the highest correlation coefficient of ApoB (r =0.553,P =0.006).Using a multiple linear regression model analysis,after adjusted for age,significant positive correlations of PCSK9 with the ApoB and LDL-C were observed.The plasma hs-CRP,interleukin-10 levels were significantly higher among patients with CAD.Using a multiple linear regression model analysis,significant correlations of PCSK9 with the hs-CRP and IL-10 in CAD patients were observed.Conclusion:The results may indicate that PCSK9 is an independent risk factor of CAD,and associate with the fomation and progression of atherosclerosis.What is more,our study demonstrated that the plasma PCSK9 levels were positively associated with hs-CRP,IL-10.