血清骨保护素、可溶性核因子κB受体活化因子配体与急性冠状动脉综合征相关性研究

Relationship between serum OPG、sRANKL levels and severity of coronary artery lesion in patients with acute coronary syndrome

目的探讨急性冠状动脉综合征(ACS)患者血清骨保护素(OPG)、可溶性核因子κB受体活化因子配体(sRANKL)的变化与冠状动脉病变程度的关系。方法随机选择南京军区福州总医院300例住院患者分为三组:ACS100例,稳定性心绞痛(SA)100例和对照组100例;采用ELISA法检测血清OPG、sRANKL;并对所有患者进行冠状动脉造影,根据造影结果对冠状动脉病变进行Gensini评分,分析二者血清水平与冠状动脉狭窄的数目及冠状动脉病变Gensini评分的相关性。结果 ACS组血清OPG水平显著高于对照组(P<0.01)及SA组(P<0.01),且随病变血管支数增加而增高(P<0.01);与之相反血清sRANKL水平显著低于对照组(P<0.01)及SA组(P<0.01),且随病变血管支数增加而减低(P<0.01);冠心病患者OPG水平与Gensini评分水平呈正相关(P<0.01);sRANKL水平与Gensini评分呈负相关(P<0.01)。结论 ACS患者血清OPG、sRANKL水平与冠状动脉病变程度有关,提示OPG系统可能通过干预血管炎症反应参与了冠状动脉粥样硬化病变进程。

Objective To analyse the relationship between the levels of serum osteoprotegerin(OPG),soluble receptor activator of nuclear factor κB ligand(sRANKL) and severity of coronary artery lesions in patients with acute coronary syndrome(ACS).Methods 350 consecutive patients were divided into three groups,ACS group(n=100),stable angina(SA)group(n=100)and the control group(n=100).Serum OPG,sRANKL were measured by enzyme linked immunosorbent assay(ELISA).All the patients had received coronary angiography(CAG).Gensini score was geiven to all patients according to the results of CAG.The relationships between the levels of serum OPG,sRANKL and the number of diseased vessels and Gensini score were analysed.Results Serum OPG levels were significantly higher in ACS group than those in SA group and control group(P<0.01).As the number of diseased vessels increased,there was a significant increase in serum OPG levels(P<0.01).In contrast,serum sRANKL levels in ACS were significantly lower than those in the control group(P<0.01) and the SA group(P<0.01).As the number of diseased vessels increased,there was a significant decrease in serum sRANKL levels(P<0.01);A positive relation was found between OPG levels and Gensini score(P<0.01).A negative relation was found between sRANKL levels and Gensini score(P<0.01).Conclusions Serum OPG,sRANKL levels are associated with the stenosis degree of the coronary artery in patients with ACS,suggesting that OPG system may be involved in the progression of Coronary atherosclerosis lesions.