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目的:了解不同冠状动脉(冠脉)病变程度的冠心病(CHD)患者血浆脂联素(APN)水平及其与胰岛素抵抗(IR)、血糖(FPG)、血脂、血压、肥胖、冠脉病变程度的关系。方法:选取冠脉造影检查者共128例作为研究对象,根据冠脉病变支数,分为单支病变组32例、双支病变组30例、多支病变组32例和冠脉造影正常的对照组34例。测量血压、身高、体重、腰围(WC)和臀围。采空腹静脉血,测定血浆APN、胰岛素(FINS)、FPG、TC、TG、HDL-C、LDL-C、载脂蛋白A1(apo-A1)和载脂蛋白B(apo-B)。计算体质指数(BMI)、腰臀比(WHR)、胰岛素敏感指数(ISI)和Gensini积分。结果:CHD各组血浆APN水平低于对照组(P<0.01)。血浆APN水平与收缩压、舒张压、WC、BMI、WHR、TC、LDL-C、FINS、Gensini积分均呈负相关(P<0.05或0.01),与ISI呈正相关(P<0.01)。均衡年龄、血压、FPG、血脂、肥胖等影响后,APN仍与Gensini积分、FINS、ISI存在相关性(P<0.01)。回归分析显示,ISI、WC和Gensini积分是影响血浆APN水平的独立因素。结论:CHD患者血浆APN水平降低并与冠脉病变程度密切相关,与IR、血脂、血压和肥胖存在一定的相关性。
Objective: To investigate the level of plasma adiponectin (APN) in patients with coronary artery disease (CHD) and its relationship with insulin resistance (IR), blood glucose (FPG), blood lipid, blood pressure, Degree of relationship. Methods: A total of 128 coronary angiography were selected as study subjects. According to the number of coronary lesions, 32 patients were divided into single vessel disease group, 30 double vessel disease group, 32 multiple vessel disease group and normal coronary angiography Control group of 34 cases. Blood pressure, height, weight, waist circumference (WC) and hip circumference were measured. Fasting venous blood was collected for determination of plasma APN, insulin (FINS), FPG, TC, TG, HDL-C, LDL-C, apolipoprotein A1 (apo-A1) and apolipoprotein B (apo-B). Body mass index (BMI), waist-hip ratio (WHR), insulin sensitivity index (ISI) and Gensini scores were calculated. Results: Plasma APN levels in CHD groups were lower than those in control group (P <0.01). Plasma APN levels were negatively correlated with systolic pressure, diastolic pressure, WC, BMI, WHR, TC, LDL-C, FINS and Gensini scores (P <0.05 or 0.01). APN was still correlated with Gensini score, FINS and ISI (P <0.01) after the effects of age, blood pressure, FPG, lipids and obesity were balanced. Regression analysis showed that ISI, WC and Gensini scores were independent factors affecting plasma APN levels. Conclusion: The plasma levels of APN in CHD patients are decreased and closely related to the degree of coronary artery disease. There is a certain correlation between them and IR, blood lipid, blood pressure and obesity.