急性冠脉综合征患者血浆瘦素水平的变化及临床意义

Evaluated Level of Leptin In Acute Coronary Syndrome and Their Relationship

目的:探讨急性冠脉综合征(ACS)患者血浆瘦素(leptin)水平的变化及其临床意义。方法:设急性心肌梗死组(AMI组)(n=30,男性)、不稳定性心绞痛组(UA组)(n=30,男性),分别抽取AMI组患者入院第1d、UA组患者心绞痛发作24h内及病情稳定后(2周无缺血事件发生)和对照组静脉血,通过酶联免疫法测定血浆leptin浓度。结果:AMI组患者入院第1d血浆leptin浓度(3.20±0.83ng/ml)较正常对照组(2.06±0.82ng/ml)显著升高,P<0.05,AMI组患者血浆leptin浓度与血浆C反应蛋白(CRP)浓度之间呈显著正相关关系(r=0.47,P<0.05);AMI组患者第1d与UA组患者心绞痛发作24h内血浆leptin水平有显著性差异,P<0.05。UA患者心绞痛发作24h内血浆leptin水平(2.67±0.79ng/ml)与病情稳定后的血浆leptin水平(2.19±0.91ng/m1)以及对照组比较,均有显著性差异,P<0.05,UA组患者病情稳定后的血浆leptin水平略高于对照组,无显著性差异,P>0.05。UA组患者心绞痛发作24h内的血浆leptin浓度与血浆CRP浓度呈显著正相关关系(r=0.76,P<0.05)。结论:男性ACS患者血浆leptin水平升高与组织炎症反应相关,leptin水平在男性ACS患者中的升高一定程度上可能代表了动脉粥样硬化斑块的易损性,是一个重要的冠心病危险因素和不稳定斑块的监测指标。

Objective：To evaluate the level of Leptin in ACS and their relationship. Methods： Plasma leptin levels were measured in 30male - patients With unstable angina（UA）on first day and 14 days later,30 male-patients with AMI on day 1 after MI. and 30 normal subjects. Other subjects were also measured. Results： Leptin levels of 30 AMI patients on first day are significantly higher than that of the UA（ p 〈 0.05）. We found that leptin correlated with CRR Leptin levels of UA were significantly higher than that of the controls（p〈 0.05）. then drop to normal after careful therapy. We found that leptin correlated with CRP in UA. Conclusion： Plasma leptin levels have a significance correlation with CRP in AMI. Leptin may play an important role in the inflammation of ACS in males. Leptin may be an important risk factor for coronary heart disease and a indicator of unstable plaque.