老年急性心肌梗死合并2型糖尿病患者PCSK9水平与冠脉病变的相关性分析

摘要

目的 探讨老年急性心肌梗死合并2型糖尿病患者血清枯草溶菌素转化酶9(PCSK9)水平及其与冠脉病变的相关性.方法 选取老年急性心肌梗死合并2型糖尿病患者46例为观察组,同期住院的老年非糖尿病急性心肌梗死患者34例为阳性对照组,慢性稳定性冠心病患者33例为阴性对照组.采用酶联免疫吸附试验(ELISA)检测血清PCSK9水平,分析其与低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、总胆固醇(TC)、糖化血红蛋白(HbA1c)、超敏C反应蛋白(Hs-CRP)和Gensini积分的相关性.结果 PCSK9、HbA1c、Hs-CRP和Gensini积分在阴性对照组、阳性对照组、观察组均依次升高,组间多重比较差异有统计学意义(P<0.05).观察组血清PCSK9水平与Hs-CRP、Gensini积分呈正相关(P<0.05),与HbA1c、TG、TC、LDL-C、HDL-C无相关性(P>0.05).结论 PCSK9与冠脉病变程度呈正相关,可用于临床辅助判断老年急性心肌梗死合并2型糖尿病患者冠脉病变严重程度.%Objective To investigate the correlation between serum proprotein convertase subtilisin/kexin 9 (PCSK9) level and the severity of angiographic coronary artery disease (CAD) in elderly patients with acute myocardial infarction (AMI) complicated with type 2 diabetes mellitus (T2DM). Methods The patients over the same period were divided into three groups:the elderly patients with AMI and T2DM (observation group, n=46), the elderly non diabetic patients with AMI (positive control group, n=34) and patients with chronic stable coronary heart disease (negative control group, n=33). The serum PCSK9 level was detected by enzyme-linked immunosorbent (ELISA) in three groups. The correlation between serum PCSK9 level and low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TG), total cholesterol (TC), glycosylated hemoglobin (HbA1c), high sensitive C reactive protein (Hs-CRP) and Gensini score were analyzed. Results The levels of PCSK9, HbA1c, Hs-CRP and Gensini score showed a gradually increased tendency in negative control group, positive control group and observation group. Multiple comparison differences between groups were statistically significant (P<0.05). The serum PCSK9 level was positively correlated with Hs-CRP and Gensini score in observation group (P<0.05), and showed no correlation with HbA1c, TG, TC, LDL-C and HDL-C (P>0.05). Conclusion The serum level of PCSK9 is positive correlated with the severity of CAD, which can be used to determine the severity of coronary artery lesions in elderly patients with AMI complicated with T2DM.