内脏脂肪素与动脉粥样硬化及血管内皮功能相关性的研究

The correlation between plasma Visfatin and atherosclerosis,endothelial function

目的:通过测定不同动脉粥样硬化(AS)程度受试者的血浆内脏脂肪素(Visfatin)水平并评估内皮功能状态,探讨血浆Visfatin在AS发生发展及血管内皮功能紊乱中的意义。方法:62例接受冠状动脉造影和颈总动脉、肱动脉超声检测的患者,采用Gensini积分系统和测定颈总动脉内-中膜厚度(IMT)评价AS严重程度后分为对照组、早期AS组、严重AS组。采用超声检测肱动脉血流介导的血管扩张(FMD)评估各组血管内皮功能。同时检测各组血浆Visfatin水平,并将其与颈总动脉IMT、冠状动脉Gensini积分及肱动脉FMD进行相关性分析。结果:①与对照组比较,AS组血浆Visfatin水平显著升高,且严重AS组高于早期AS组(P<0.01);②血浆Visfatin水平与颈总动脉IMT呈正相关(r=0.475;P<0.01);③血浆Visfatin水平与冠状动脉Gensini积分呈正相关(r=0.359;P<0.01);④血浆Visfatin水平与肱动脉FMD呈负相关(r=-0.488;P<0.01)。结论:血浆Visfatin水平与AS的发生和发展密切相关。AS患者血浆Visfatin水平的高低能初步反映血管内皮功能受损的状况和AS的严重程度,提示血浆Visfatin水平可能是一个新的心血管疾病预测因子。

Objective：The aim of the present study was to explore the correlation between plasma Visfatin and atherosclerosis （AS）, endothelial function through comparing the plasma levels of Visfatin and endothelial function in mild or severe AS subjects, and evaluate the clinical significance of Visfatin in predicting the development of AS and endothelial dysfunction. Method：Six-two subjects were undergone coronary angiography and ultrasound detec- tion of carotid and brachial artery. The severities of coronary stenosis and carotid atherosclerosis were determined by Gensini score and carotid intima-media thickness （IMT）, respectively. The flow mediated dilation （FMD） of brachial artery was also measured by color Doppler ultrasound. Based on the results of coronary angiography and carotid ultrasound, the subjects were classified into three groups： control （no AS）, mild AS and severe AS groups. The plasma levels of Visfatin were measured. The correlation between Visfatin and carotid IMT, Gensini score were analyzed. Also, the relation between Visfatin and the FMD of brachial artery were investigated. Result： Plasma level of Visfatin was elevated in both mild and severe AS comparing with the control, and it increased more significantly in severe AS than that in mild AS. Moreover, plasma level of Visfatin was positively correlated with carotid IMT and Gensini whereas negatively correlated with the FMD of brachial artery. Conclusion： The plasma level of Visfatin is closely correlated with the genesis and development of AS and the endothelial function. It might be used as a clinical marker to predict the degree of AS and the status of endothelia function.