血清铁蛋白与颈动脉粥样硬化及心血管病危险因素相关关系的研究

Relationships of serum ferritin with arteriosclerosisand other cardiovascular risk factors

目的:进一步探讨在动脉粥样硬化高危人群中,血清铁蛋白(SF)与动脉粥样硬化形成及其它心血管病危险因素之间的关系。方法:随机抽选88例动脉粥样硬化高危患者,以高分辨率B型超声法测定其颈动脉内膜中层厚度,观察斑块的有无并计算Crouse积分,以此作为评价动脉粥样硬化的指标,根据颈动脉内膜中层厚度是否≥0.8mm和(或)有无颈动脉粥样硬化斑块形成分为颈动脉正常组和异常组。酶联免疫定量测定SF水平。结果:发现异常组SF水平较正常组明显升高(P<0.01);异常组年龄较正常组显著增加(P<0.01)。以SF≥300mg/L为界分为SF升高组及正常组,发现升高组较正常组的平均内膜中层厚度、最大内膜中层厚度及Crouse积分均显著升高(P<0.01,P<0.01,P<0.01)。直线相关与回归分析发现,SF与平均内膜中层厚度、最大内膜中层厚度及Crouse积分之间均呈明显的正相关(r=0.294,P<0.01;r=0.238,P<0.05;r=0.391,P<0.01)。以SF为因变量,多种心血管病危险因素定量指标为自变量,多因素逐步回归分析发现,SF水平与年龄、血压、血脂、血糖及血清C反应蛋白水平均无明显的相关性。吸烟者SF水平较不吸烟者显著升高(P<0.05)。结论:SF水平升高即体内储存铁过多是动脉粥样硬化形成和进展的危险因素,从而进一步支持了“铁假说”。吸烟可能对体内铁负荷过多有促进作用。

Objective： To evaluate the relationships of serum ferritin （SF） with arteriosclerosis and other cardiovascular risk factors. Methods： IMT and plaque were detected in 88 patients with high risks of arteriosclerosis by ultrasound of high resolution power. The Crouse was scored. The level of SF was determined by microwell ferritin EIA. Patients were separated to normal and abnormal group according to： （1） whether the IMT≥0.8 mm or not, （2） whether the plaque existed or not. Results： The SF was significantly higher in abnormal group than that in normal group（P〈0.01）, patients were significantly older in the abnormal group than that in the normal group （P〈0.01）. The average value of carotid IMT （IMTmean）, the peak value of carotid IMT （IMTmax） and the Crouse score of patients with SF≥ 300 μg/L was significantly higher than those with SF〈300μg/L （P〈0.01, P〈0.01, P〈0.01）. The level of SF was positive correlated with average value of carotid IMT（IMTmean）, the peak value of carotid IMT（IMTmax） and the Crouse score on linear correlation and regression analysis （r=0.294,P〈0.01,r=0.238,P〈0.05; r=0.391, P〈0.01 ）. The level of SF was not correlated with age, blood pressure, lipids, blood glucose and CRP on multiple stepwise regression analysis. The level of SF was significantly higher in patients with smoking than that in patients without smoking （P〈0.05）. Conclusion： Iron plays an important role in the development of arteriosclerosis.