非糖尿病的冠心病患者糖基化终末产物水平及其清除率变化

摘要

Objective:To study the changes of levels of serum AGEs in nondiabetic patients with coronary heart disease and the changes of renal clearance of AGEs.Methods:The serum and clinical data of patients who were taken in hospital and taken coronary angiography were collected during November 2013 to March 2014, and there were 42 patients with coronary heart disease (CHD, coro-nary heart disease group) , including 30 patients with acute coronary syndrome ( ACS group) and 12 patients with chronic CHD ( chron-ic CHD, group) , and 27 patients without CHD ( control group) .And the serum, urine levels of AGES were determined by ELISA, and the clearance rate was calculated.Results:The levels of AGEs in the non -ACS group was lower than coronary heart disease, chronic coronary heart disease group were significantly different (63.40 ±11.47 vs.85.32 ±37.09 vs.90.29 ±31.59 ng/ml, P =0.023, 0.033), there was no statistically significant difference (P =0.681) ACS group with chronic CHD.However, there were no difference between AGEs and hsCRP, creatinine clearance (P>0.05).AGEs clearance rates in the non-ACS group was higher than coronary heart disease, chronic coronary heart disease group were significantly different (1.88 ±1.00 vs.0.99 ±0.38 vs.0.90 ±0. 41 ml/min, P =0.001, 0.002).No statistically significant difference (P =0.759) between ACS group and chronic coronary heart disease group remained.Conclusion:Serum levels of AGEs in non -diabetic patients with coronary heart disease wene increased, and clearance rate decreased, the serum levels and clearance rates of AGEs have predictive value in diagnosis of coronary heart dis-ease.%目的：研究非糖尿病的冠心病患者的血清糖基化终末产物（ AGEs ）水平及其清除率较非冠心病患者的变化。方法：收集2013-11～2014-03间经中山大学附属孙逸仙纪念医院冠脉造影确诊为冠心病42例患者（冠心病组），其中急性冠脉综合征30例（ ACS亚组），慢性冠心病12例（归为慢性冠心病组）、非冠心病27例（归为对照组）的血清及其临床资料，以ELISA的方法测定AGEs血清、尿液水平，并计算出AGEs清除率。结果：AGEs水平在非冠心病组低于ACS、慢性冠心病患者（63．40±11．47 vs．85．32±37．09 VS．90．29±31．59 ng／ml， P分别为0．023，0．033），ACS与慢性冠心病组没有统计学差异（P＝0．681）。但AGEs水平与血肌酐、hsCRP、肌酐清除率无明显相关性（P＞0．05）。 AGEs清除率ACS亚组、慢性冠心病亚组均低于非冠心病组（1．88±1．00 vs．0．99±0．38 vs．0．90±0．41 ml／min， P分别为0．001，0．002）。 ACS组与慢性冠心病组没有统计学差异（P＝0．759）。结论：非糖尿病的冠心病患者AGEs血清水平增高，清除率下降，AGEs血清水平及其清除率可能对冠心病诊断有临床价值。