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目的研究血清前蛋白转化酶枯草溶菌素9(PCSK9)在冠心病慢性心力衰竭中的变化和临床意义。方法选取2016年1~8月我院心内科符合诊断要求的45例冠心病慢性心力衰竭患者作为病例组,同时选取40例无心力衰竭的冠心病患者作为对照组,比较两组的血清胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、PCSK9、高敏C反应蛋白(hsCRP)的浓度。所有患者均于入院第2天早晨空腹抽取外周静脉血5 ml,病例组治疗后再次抽取外周静脉血5 ml,测定血清PCSK9、hsCRP水平。结果两组的TC、TG、LDL-C、HDL-C水平比较,差异无统计学意义(P>0.05)。病例组治疗前的PCSK9及hsCRP水平显著高于对照组治疗前,差异有统计学意义(P<0.05)。病例组治疗前后的血浆PCSK9、hsCRP水平比较,差异有统计学意义(P<0.05);对照组治疗前后的PCSK9、hsCRP水平比较,差异无统计学意义(P>0.05)。病例组治疗后的PCSK9、hsCRP水平显著低于对照组治疗后,差异有统计学意义(P<0.05)。结论患者血清PCSK9水平与慢性心力衰竭密切相关,其可能通过促炎症反应参与慢性心力衰竭的发病过程,可为临床预测及寻找新的慢性心力衰竭治疗及干预措施提供新思路。
Objective To study the changes and clinical significance of serum prokaryotic protein convertase subtilisin 9 (PCSK9) in patients with chronic heart failure of coronary heart disease. Methods Forty-five CHD patients with coronary heart disease in our hospital from January to August 2016 were selected as the case group and 40 CHD patients without heart failure as the control group. The serum cholesterol TC, TG, LDL-C, HDL-C, PCSK9 and hsCRP were measured. All patients were fasting on the second day of admission on the morning of 5 ml of peripheral venous blood, the patients in the treatment group were drawn again 5 ml of peripheral venous blood, measured serum levels of PCSK9, hsCRP. Results There were no significant differences in TC, TG, LDL-C and HDL-C between the two groups (P> 0.05). The levels of PCSK9 and hsCRP before treatment in the case group were significantly higher than those in the control group before treatment, the difference was statistically significant (P <0.05). The levels of plasma PCSK9 and hsCRP before and after treatment in the case group were significantly different (P <0.05). The levels of PCSK9 and hsCRP before and after treatment in the control group were not significantly different (P> 0.05). The levels of PCSK9 and hsCRP in the case group were significantly lower than those in the control group after treatment (P <0.05). Conclusion Serum PCSK9 level is closely related to chronic heart failure. It may participate in the pathogenesis of chronic heart failure through proinflammatory response, which may provide new ideas for clinical prediction and finding new treatment and intervention measures for chronic heart failure.