急性冠状动脉综合征患者血清抵抗素水平研究

Study of serum resistin level in patients with acute coronary syndrome

目的探讨急性冠状动脉综合征患者血清抵抗素水平的变化及其可能的病理生理意义。方法酶联免疫法测定37例急性冠状动脉综合征患者,其中急性心肌梗死19例(急性心肌梗死组),不稳定性心绞痛18例(不稳定性心绞痛组)和26例正常对照组的空腹血清抵抗素水平。结果急性冠状动脉综合征患者血清抵抗素水平[(11.60±5.98)μg/dl]高于正常对照组[(4.17±2.24)μg/dl,P<0.05],其中急性心肌梗死组抵抗素水平[(15.12±5.06)μg/dl]明显高于不稳定性心绞痛组[(7.67±4.28)μg/dl,P<0.05];抵抗素水平与心肌肌酸激酶及其同工酶、肌钙蛋白I峰值呈正相关(分别r=0.541,P<0.01;r=0.508,P<0.01;r=0.545,P<0.01),与体内脂肪百分比及高密度脂蛋白胆固醇呈负相关(分别r=-0.386,P<0.05;r=-0.335,P<0.05)。结论血清抵抗素水平与心肌损伤大小、体内脂肪分布和高密度脂蛋白胆固醇有关,提示抵抗素可能参与了动脉粥样硬化和急性冠状动脉综合征的发病。

Objective To evaluate the changes of serum resistin level in patients with acute coronary syndrome and its possible pathologic role. Methods Fasting serum resistin levels were measured in 37 patients with acute coronary syndrome （acute myocardial infarction 19 cases, unstable angina pectoris 18 cases ）and 26 normal control subjects with enzyme-linked immunosorbent assay. Results The serum resistin level in acute coronary syndrome patients was significantly higher than that in healthy controls（ 11.60 ± 5.98μg/dl vs 4.17 ± 2.24μg/dl, P 〈 0.05）and the serum resistin level in acute myocardial infarction group was significantly higher than that in unstable angina pectoris group （ 15.12 ± 5.06μg/dl vs 7.67 ±4.28μg/dl, P 〈 0.05）. The senun resistin level was positively correlated with the peak value of troponin I, creatine phosphokinase and its MB isoenzyme（ r =0.545, P 〈0.01; r =0.541, P 〈0.01; r =0.508, P 〈0.01,respectively）,and was negatively correlated with body fat percentage and high density hpoprotein（ r = - 0.386, P 〈 0.05 ; r = -0. 335, P 〈 0.05, respectively）. Conclusions Serum resistin level is associated with the size of injured myocardium, serum lipoprotein and body fat. Resistin may be involved in the development of atherosclerosis and acute coronary syndrome.