冠心病患者血清脂联素、YKL-40水平的变化及其与冠状动脉病变程度的关系

陈启; 马礼坤; 孙向东; 桑更生; 吴金

冠心病患者血清脂联素、YKL-40水平的变化及其与冠状动脉病变程度的关系

Change of serum levels of adiponectin and YKL-40 in patients with different coronary heart diseases and its correlation with the severity of coronary artery lesion

摘要

摘要: 目的:探讨冠心病患者血清脂联素、YKL-40水平的变化及其与冠状动脉病变程度和粥样硬化斑块稳定性的关系。方法:选取行冠状动脉造影者94例作为研究对象,根据冠状动脉造影结果结合临床病史分为正常对照组、稳定型心绞痛(SAP)组、不稳定型心绞痛(UAP)组和急性心肌梗死(AMI)组,根据冠状动脉病变血管数分为正常对照组、单支病变组、双支病变组、三支病变组,测定并比较各组血清脂联素、YKL-40水平。采用Gensini积分系统评定冠状动脉血管病变狭窄程度与脂联素、YKL-40的相关性。结果:AMI组、UAP组、SAP组血清脂联素水平均低于对照组(P<0.05~P<0.01),AMI组、UAP组低于SAP组(P<0.01),UAP组与AMI组差异无统计学意义(P>0.05)。AMI组、UAP组、SAP组血清YKL-40水平均高于对照组(P<0.05~P<0.01),AMI组、UAP组高于SAP组(P<0.01),UAP组与AMI组差异无统计学意义(P>0.05)。对照组、单支病变组、双支病变组、三支病变组血清脂联素水平依次降低,差异均有统计学意义(P<0.05~P<0.01),而血清YKL-40水平依次升高,差异亦均有统计学意义(P<0.05~P<0.01)。脂联素与Gensini积分呈负相关关系(P<0.01),YKL-40与Gensini积分呈正相关关系(P<0.01)。结论:血清脂联素和YKL-40水平与冠状动脉病变程度和粥样硬化斑块的不稳定性有关,病变越重、斑块不稳定者脂联素越低,而YKL-40水平越高。

Abstract: Objective: To investigate the change of serum levels of adiponectin and YKL-40 in patients with different coronary heart diseases (CHD),and its relationship with the severity of coronary artery lesion and the stability of atherosclerotic plaque.Methods: Ninety-four patients undergoing coronary angiography were included in the study.According to the opacification results and clinical history,the patients were divided into normal control group,stable angina pectoris (SAP) group,unstable angina pectoris (UAP) group and acute myocardial infarction (AMI) group;according to the number of coronary artery stenosis,they were divided into normal control group,single vessel disease group,double vessels disease group and three vessels disease group.Serum levels of adiponectin and YKL-40 were determined and compared among different groups.The degree of coronary artery stenosis was assessed by Gensini score,and the correlation between serum levels of adiponectin,YKL-40 and Gensini score was analyzed.Results: Serum adiponectin concentration in all the groups with CHD was lower than that of controls (P<0.05 to P<0.01).The serum adiponectin concentration in AMI group and UAP group was lower than that of SAP group (P<0.01).No significant difference was found between UAP group and AMI group (P>0.05).Serum YKL-40 concentration in all the groups with CHD was higher than that of controls (P<0.05 to P<0.01).Serum YKL-40 concentration in AMI group and UAP group was higher than that of SAP group (P<0.01).No significant difference was observed between UAP group and AMI group (P>0.05).The serum adiponectin concentration was decreased among normal control group,single vessel disease group,double vessels disease group and three vessels disease group (P<0.05 to P<0.01).The serum YKL-40 concentration was increased among normal control group,single vessel disease group,double vessels disease group and three vessels disease group (P<0.05 to P<0.01).Serum adiponectin concentration was negatively correlated with Gensini score (P<0.01),and serum YKL-40 concentration was positively correlated with Gensini score (P<0.01).Conclusions: The serum levels of adiponectin and YKL-40 are correlated with the degree of coronary artery lesion and instability of atherosclerotic plaque.Patients with serious coronary artery lesion and instable atherosclerotic plaque have a lower serum level of adiponectin and a higher serum level of YKL-40.

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