冠心病患者胰岛素抵抗及血浆高敏C反应蛋白检测

Detection of insulin resistance and plasma high sensitive C-reactive protein of coronary heart disease patient

目的:探讨胰岛素抵抗(IR)及高敏C反应蛋白(hs-CRP)与冠心病患者冠状动脉病变的相关性。方法:选择经冠状动脉造影证实的冠心病患者共73例,其中稳定型心绞痛(SAP)31例,不稳定型心绞痛(UAP)23例,急性心肌梗死(AMI)19例,另选冠状动脉造影正常的15例作为对照组。血浆hs-CRP水平测定采用微粒增强免疫投射比浊法,血清胰岛素含量测定采用酶联免疫吸附法,依据稳态模式评估法计算胰岛素抵抗指数(IRI),衡量冠状动脉病变程度采用Gensini积分系统。结果:冠心病患者IRI和血浆hs-CRP水平高于对照组(P<0.05);冠心病患者中,AMI组和UAP组IRI和hs-CRP高于SAP组;冠心病患者Gensini积分与IRI、hs-CRP,IRI与hs-CRP均呈正相关(r分别为0.921,0.669,0.619,P均<0.01)。结论:IR和hs-CRP可能与斑块的不稳定状态有关,2者相互影响、相互作用,参与了冠心病的发生发展。

Aim： To explore the correlation between plasma high sensitive C-reactive protein （hs-CRP）, insulin resistance （IR） and the severity of coronary artery lesion of coronary heart disease （CHD）. Methods：A total of 88 in-patients who received coronary angiography were allocated into 4 groups： normal control group（ n = 15 ） , stable angina pectoris （SAP） group（ n = 31 ） , unstable angina pectoris （UAP） group（ n = 23 ） , acute myocardial infarction （AMI） group （ n = 19）. The plasma hs-CRP level was measured with immune-reinforced turbidimetry methods. The concentration of serum insulin was measured using ELISA, IRI was calculated by HOMA model. Gensini score was measured according to the severi- ty of coronary artery lesions. Results：The plasma hs-CRP level and IRI of CHD patients were significantly higher than those of the normal control group（P 〈 0.05 ）. Among CHD groups, the plasma hs-CRP level and IRI in AMI group and UAP group were significantly higher than those in SAP group （ P 〈 0.05）. Pearson relation analysis showed that ： Gensini score was positively related with IRI hs-CRP, IRI was positively related with hs-CRP（ r were 0. 921,0. 669 and 0. 619 ,respectively, P 〈 0.05）. Conclusion： IR and hs-CRP were both related with the instability of plaques. IR and hs-CRP affect and promote each other and play an important role in the development of CHD.