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目的通过测定急性冠脉综合征(acute coronary syndrome,ACS)患者血清脂联素(adiponectin,APN)及血红素加氧酶-1(heme oxygenase-1,HO-1)水平,分析其与冠状动脉病变程度的相关性,探讨二者在冠心病中的相互作用。方法入选160例行冠状动脉造影(CAG)患者,根据患者病史及CAG结果分为2组:急性冠脉综合征(ACS)组92例,稳定型心绞痛(SAP)组68例;50例对照组为非冠心病CAG阴性组。用Gensini评分系统对冠脉病变程度评分。根据Gensini评分系统对冠脉病变组分为Gensini积分≥30分组和<30分组,再根据冠脉病变支数分为单只、双支和3支病变组。采双抗体夹心ELISA法测定ACS组、SAP组、正常对照组血清APN、HO-1水平。分别比较其二者之间的相关性及与冠脉病变的严重程度(Gensini积分)的相关性。结果 ACS组和SAP组血清APN及HO-1水平均明显低于对照组[(5.84±2.29)、(8.01±2.04)vs(15.27±2.51)mg/L;(24.08±7.88)、(32.86±10.97)vs(54.35±14.8)μg/L,P<0.01]。按冠状动脉病变支数分组,冠状动脉病变支数多者血清APN、HO-1水平较冠状动脉病变支数少者亦显著降低。Gensini积分≥30分APN、HO-1水平[(5.75±2.28)mg/L、(22.27±6.5)μg/L]明显低于<30分组[(7.55±2.29)mg/L、(32.38±10.6)μg/L,P<0.01]。APN与HO-1呈正相关(r=0.598,P<0.01),Gensini积分与血清APN、HO-1水平均呈负相关(r=-0.576,P<0.01;r=-0.456,P<0.01)。结论血清APN与HO-1密切相关,且与冠状动脉病变严重程度密切相关,且二者之间可能存在相互调节。
Objective To determine the level of serum adiponectin (APN) and heme oxygenase-1 (HO-1) in patients with acute coronary syndrome (ACS) The correlation between the degree of lesion and the interaction between the two in coronary heart disease. Methods One hundred and sixty patients underwent coronary angiography (CAG) were divided into two groups according to their medical history and CAG: 92 in ACS group, 68 in SAP group and 50 in control group CAG negative for non-coronary heart disease. Coronary lesions were graded using the Gensini scoring system. According to the Gensini scoring system, the coronary lesions were grouped into Gensini score≥30 and <30, and then divided into single, double and triple lesions according to the number of coronary lesions. The levels of serum APN and HO-1 in ACS group, SAP group and normal control group were detected by ELISA. The correlations between the two and the severity of coronary lesions (Gensini score) were compared. Results The levels of serum APN and HO-1 in ACS group and SAP group were significantly lower than those in control group (5.84 ± 2.29 vs 8.01 ± 2.04 vs 15.27 ± 2.51 mg / L, (24.08 ± 7.88) and (32.86 ± 10.97) vs (54.35 ± 14.8) μg / L, P <0.01]. According to the number of coronary artery lesion, the serum APN and HO-1 levels in patients with more coronary lesions were significantly lower than those with fewer coronary lesions. The levels of APN and HO-1 in Gensini group were significantly lower than those in group <30 [(7.55 ± 2.29) mg / L, [(5.75 ± 2.28) mg / L and (22.27 ± 6.5) μg / L, ) μg / L, P <0.01]. There was a positive correlation between APN and HO-1 (r = 0.598, P <0.01). Gensini score was negatively correlated with serum APN and HO-1 levels (r = -0.576, . Conclusion Serum APN is closely related to HO-1 and is closely related to the severity of coronary artery disease, and there may be mutual regulation between the two.