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目的研究血浆补体因子H(CFH)、超敏C反应蛋白(hsCRP)和胰岛素抵抗(IR)与冠心病(CAD)关系。方法采用JUdkins法行冠状动脉造影(CAG),排除冠心病(非冠心病组)204例,确诊冠心病155例。其中,冠脉病变血管1支组80例、2支组41例、3支组34例;按临床亚型可分稳定型心绞痛(SA)组62例、不稳定型心绞痛(UA)组69例和心肌梗死(MI)组24例。应用酶联免疫法测定血浆CFH浓度、Backman生化分析仪测定hsCRP、空腹血糖、胰岛素和血脂等指标。根据HOMA Model计算IR指数(IRI)。结果冠心病组IRI明显高于非冠心病组(3.89±1.89 vs 3.40±1.80)(P<0.05),MI组IRI(4.39±2.62)、UA组IRI(4.36±1.61)均明显高于SA组(3.19±1.14),(P<0.05);校正年龄、性别、吸烟史、高血压史和冠心病家族史后,hsCRP是冠心病的独立危险因素(OR:1.417,95%CI:1.236～1.625,P<0.05);IR与hsCRP的相关系数r为0.186,P<0.01。血浆CFH浓度在组间无差别。三个指标在不同病变血管支数组中没有差别。结论hsCRP为冠心病的独立危险因子,IR可以预测冠心病,CFH与冠心病无关。
Objective To study the relationship between plasma complement factor H (CFH), high sensitivity C-reactive protein (hsCRP) and insulin resistance (IR) and coronary heart disease (CAD). Methods The coronary artery angiography (CAG) was performed by JUdkins method, 204 cases of coronary heart disease (non-coronary heart disease group) were excluded and 155 cases were diagnosed as coronary heart disease. Among them, there were 80 cases of coronary artery disease, 41 cases of 2 branches and 34 cases of 3 branches.According to the clinical subtype, there were 62 cases of stable angina (SA) group and 69 cases of unstable angina pectoris (UA) And myocardial infarction (MI) group of 24 cases. The concentration of plasma CFH was measured by enzyme-linked immunosorbent assay (ELISA) and hsCRP, fasting blood glucose, insulin and lipids were measured by Backman biochemical analyzer. The IR Index is calculated from the HOMA Model. Results The IRI in CHD group was significantly higher than that in non-CHD group (3.89 ± 1.89 vs 3.40 ± 1.80) (P <0.05). IRI in MI group was 4.39 ± 2.62 and IRI in UA group was significantly higher than that in SA group (3.19 ± 1.14), P <0.05; hsCRP was an independent risk factor for coronary heart disease after adjusting for age, sex, smoking history, history of hypertension and family history of coronary heart disease (OR: 1.417, 95% CI: 1.236-1.625 , P <0.05). The correlation coefficient between IR and hsCRP was 0.186, P <0.01. Plasma CFH concentrations did not differ between groups. There was no difference between the three indexes in the different lesion vessel count groups. Conclusion hsCRP is an independent risk factor for coronary heart disease, IR can predict coronary heart disease, CFH has nothing to do with coronary heart disease.