红细胞膜总胆固醇含量与急性冠状动脉综合征的相关性研究

Reasearch on the relationship of cholesterol content of erythrocyte membranes and acute coronary syndrome

目的探讨红细胞膜胆固醇含量(CEM)与急性冠状动脉综合征(ACS)的相关性。方法 511例胸痛患者行冠状动脉造影后分成四组:稳定性心绞痛(SAP)组96例、非ST段抬高型急性冠状动脉综合征(N-ST-ACS)组199例、ST段抬高型急性冠状动脉综合征(ST-ACS)组101例、冠状动脉造影正常的不典型胸痛对照(Control)组115例。测定各组CEM水平及血浆hs-CRP水平。结果与SAP组比较,N-ST-ACS组(127.82μg/mg,107.50～155.32μg/mg)与ST-ACS组(130.56μg/mg,118.34～148.18μg/mg)患者CEM明显升高(P<0.01);而CEM在SAP组(77.05μg/mg,64.87～92.74μg/mg)与Control组(83.43μg/mg,65.04～95.13μg/mg)之间无明显差异。多因素逻辑回归分析提示CEM与N-ST-ACS(OR32.043,95%CI12.964～79.203,P<0.01)及ST-ACS均有显著相关性(OR53.926,95%CI19.506～149.084,P<0.01)。统计结果显示CEM与病变血管数目呈正相关(r=0.445,P<0.01),同时发现在SAP与ST-ACS两组患者中CEM与hs-CRP有正相关性(r=0.174,P<0.05)。结论 CEM水平与ACS具有显著的相关性,说明CEM可能参与ACS的病理生理过程,而且CEM作为反映ACS的意义可能优于hs-CRP。

Objective To investigate the changes and clinical significance of cholesterol content of erythrocyte membranes (CEM) in patients with acute coronary syndrome (ACS).Methods CEM levels and plasma hs-CRP from 511 subjects with the main complaint of chest pain,undergoing coronary artery angiography in three different groups,including N-ST-ACS (n=199),ST-ACS (n=101),stable angina pectoris (SAP) (n=96) and normal coronary artery (control group) (n=115),were measured using an enzymatic assay.Results CEM levels in the N-ST-ACS (127.82 μg/mg,107.50-155.32 μg/mg) and ST-ACS (130.56 μg/mg,118.34-148.18 μg/mg) groups were significantly higher than SAP group (P<0.01).There was no statistical difference between SAP (77.05 μg/mg,64.87-92.74 μg/mg) and Control groups (83.43 μg/mg,65.04-95.13 μg/mg).Multivariable logistic regression analyses revealed a significant independent relation between CEM levels and N-ST-ACS (OR 32.043,95% CI 12.964-79.203,P<0.01) or ST-ACS (OR 53.926,95% CI 19.506-149.084,P<0.01).Correlation analysis showed there was a significant association between CEM and serum hs-CRP (r=0.174,P<0.05) in the patients of SAP and ST-ACS groups.Conclusions CEM levels are correlated with ACS,which suggested that CEM may be involved in the progression of the disease,and may be a better predictor of ACS than hs-CRP.