半胱氨酸蛋白酶抑制剂C、同型半胱氨酸与冠心病的关系

Relationship among serum cystatin C、homocysteine and coronary heart diseases

目的:探讨血清半胱氨酸蛋白酶抑制剂C(cystatin C)和同型半胱氨酸(Hcy)浓度与冠心病(CHD)的关系。方法:选择经冠状动脉造影检查的患者共162例,分为对照组(60例)、稳定型心绞痛组(50组)和急性冠脉综合征组(52例)三组,采用双抗夹心ELISA法检测血清cystatin C和Hcy的浓度,并进行统计学分析。结果:①冠心病患者血清cystatin C水平明显低于对照组,而Hcy含量显著高于对照组,且二者均与病情严重程度相关(P均<0.01);②冠心病患者血清cystatin C水平与Hcy呈负相关(r=-0.444,P<0.01);③冠心病患者的左室射血分数(LVEF)、二尖瓣环收缩期运动峰值速度(Sm)明显降低,且ACS组的降低较SAP组的更为明显(P<0.01);④冠心病患者血清cystatinC浓度与LVEF、Sm呈正相关(r=0.213～0.280,P<0.05～<0.01),反之,Hcy与LVEF、Sm呈负相关(r=-0.347～-0.403,P<0.01)。结论:Cystatin C、Hcy与冠心病的发生有密切关系,可以间接反映冠心病患者的病情程度及心脏功能;Cystatin C对冠心病患者有一定的保护作用。

Objective： To investigate the relationship among serum cystatin C, homocysteine （Hcy） concentrations and coronary heart disease （CHD）. Methods： The study enrolled 162 patients who underwent a selective coronary angiography. All the patients were divided into three groups： healthy control group （n=60）,stable angina pectoris group （n= 50） and acute coronary syndrome group （n=52）. Serum cystatin C and Hcy concentrations were measured by ELISA assay. The detected parameters were analyzed at the same time. Results： （1）Concentration of serum cystatin C in patients was lower than it in normal persons, but concentration of serum Hcy was higher than it in normal persons. And the lower or higher of the concentration was, the more serious of CHD was （P〈0.01） ; （2）Cystatin C concentration of CHD group had negative correlation with Hcy（ r = - 0. 444, P〈0.01） ; （3） Left ventrieular ejection fraction （LVEF） and peak systolic velocity of mitral annular（Sm） in CHD were lower than those in normal person, and the lower of that was, the more serious of CHD was（P〈0.01） ;（4）Serum cystatin C concentration of CHD group had positive correlation with LVEF and peak systolic velocity of mitral annular（r=0. 213~0. 280, P〈0.05~0.01）, whil Hcy has negative correlation with LVEF and Sm（ r= -0. 347 -- 0. 403, P〈0.01 all）. Conclusion： There is close relationship among cys- tatin C, Hcy and development of coronary heart diseases. They can reflect the severity of coronary heart disease and heart function indirectly. Cystatin C may play a protective role in patients with coronary heart disease.