冠心病患者血清白细胞介素17A、血管内皮生长因子、25-羟维生素D3水平变化及其与冠状动脉狭窄程度的相关性分析

Changes of serum IL-17A,VEGF,25(OH)D3 levels in patients with coronary heart disease and their correlation with severity of coronary artery stenosis

目的探讨冠心病(CHD)患者血清白细胞介素17A(IL-17A)、血管内皮生长因子(VEGF)、25-羟维生素D3[25(OH)D3]水平变化及其与冠状动脉狭窄程度的相关性。方法选取临汾市人民医院2017年6月至2018年6月收治的CHD患者40例为观察组,选取该院同期体检健康者60例为对照组。记录两组一般资料,采用全自动生化检测仪检测受试者生化指标,酶联免疫吸附试验(ELISA)检测受试者血清IL-17A、VEGF、25(OH)D3水平,采用Gensini积分评价冠状动脉狭窄程度,采用SPASS Pearson软件分析冠心病患者血清IL-17A、VEGF、25(OH)D3水平与冠状动脉狭窄程度的关系。结果观察组收缩压、舒张压、糖尿病比例、高血压比例、高脂血症比例、饮酒比例、吸烟史比例及Gensini积分分别为(140.64±17.65)mmHg、(98.31±9.37)mmHg、20例(50.0%)、31例(77.5%)、26例(65.0%)、22例(55.0%)、20例(50.0%)、(27.43±3.26)分,对照组分别为(128.15±15.60)mmHg、(79.52±10.44)mmHg、17例(28.3%)、34例(56.6%)、27例(45.0%)、21例(35.0%)、18例(30.0%)、(3.10±1.02)分,两组差异均有统计学意义(t=3.629、9.382,χ^2=4.833、4.579、3.854、3.917、4.074,t=45.730,均P<0.05);观察组脂蛋白α、血糖分别为(1.46±0.41)g/L、(5.60±1.17)mmol/L,均显著高于对照组的(1.31±0.27)g/L、(5.20±0.56)mmol/L(t=2.038、2.014,均P<0.05);观察组血清IL-17A、VEGF分别为(43.82±5.18)ng/L、(83.77±17.80)ng/L,均显著高于对照组的(37.28±4.37)ng/L、(56.62±16.48)ng/L(t=6.576、7.695,均P<0.05),25(OH)D3为(15.15±8.67)pg/L,显著低于对照组的(37.34±16.20)pg/L(t=8.874,P<0.05)。经SPASS Pearson软件分析,冠心病患者血清IL-17A、VEGF与Gensini积分呈正相关(r=0.567、0.633,均P<0.05),25(OH)D3水平与Gensini积分呈负相关(r=-0.618,P<0.05)。结论CHD患者血清IL-17A、VEGF显著升高,其与冠状动脉狭窄程度呈正相关;血清25(OH)D3水平显著降低,其与冠状动脉狭窄程度呈负相关。

Objective To investigate the changes of serum IL-17A,VEGF,25(OH)D3 levels in patients with coronary heart disease(CHD)and their correlation with severity of coronary artery stenosis.Methods From June 2017 to June 2018,40 CHD patients treated in the People's Hospital of Linfen were selected as observation group.At the same time,60 healthy subjects were selected as control group.The general data of the two groups were recorded.The levels of serum IL-17A,VEGF,25(OH)D3 were measured by enzyme-linked immunosorbent assay(ELISA),and the degree of coronary stenosis was evaluated by Gensini integral.SPASS Pearson software was used to analyze the relationship between the levels of serum IL-17A,VEGF,25(OH)D3 and coronary artery stenosis course in patients with CHD.Results The proportions of systolic blood pressure,diastolic blood pressure,diabetes,hypertension,hyperlipidemia,alcohol consumption,smoking history and Gensini in the observation group were(140.64±17.65)mmHg,(98.31±9.37)mmHg,20 cases(50.0%),31 cases(77.5%),26 cases(55.0%),22 cases(55.0%),20 cases(50.0%),(27.43±3.26)points,respectively,which in the control group were(128.15±15.60)mmHg,(79.52±10.44)mmHg,17 cases(28.3%),34 cases(56.6%),27 cases(45.0%),21 cases(35.0%),18 cases(30.0%),(3.10±1.02)points,respectively,the differences between the two groups were statistically significant(t=3.629,9.382,χ^2=4.833,4.579,3.854,3.917,4.074,t=45.730,all P<0.05).The lipoproteinα,blood glucose in the observation group were(1.46±0.41)g/L and(5.60±1.17)mmol/L,respectively,which were significantly higher than those in the control group[(1.31±0.27)g/L and(5.20±0.56)mmol/L](t=2.038,2.014,all P<0.05).The serum levels of IL-17A and VEGF in the observation group were(43.82±5.18)ng/L,(83.77±17.80)ng/L,respectively,which were significantly higher than those in the control group[(37.28±4.37)ng/L,(56.62±16.48)ng/L](t=6.576,7.695,all P<0.05).The 25(OH)D3 level of the observation group was(15.15±8.67)pg/L,which was significantly lower than that of the control group[(37.34±16.20)pg/L](t=8.874,P<0.05).The results of SPASS Pearson analysis showed that there was positive correlation between the levels of serum IL-17A,VEGF and Gensini score(r=0.567,0.633,all P<0.05),the negative correlation between the level of serum 25(OH)D3 and Gensini score in patients with CHD(r=-0.618,P<0.05).Conclusion The levels of serum IL-17A,VEGF in patients with CHD are significantly higher,which are positively correlated with the degree of coronary artery stenosis.The serum 25(OH)D3 level decreases significantly,which is negatively correlated with the degree of coronary artery stenosis.