冠心病及冠心病等危症患者血浆脂联素、氮端脑利钠肽前体的测定及相关性研究

Determination and correlation research of adiponectin and N-terminal pro brain natriuretic peptide in patients with coronary artery disease and its equivalents

目的探讨测定血浆脂联素(adiponectin,APN)与氮端脑利钠肽前体(N-terminal pro brain natriuretic peptide,NT-proBNP)浓度在反映动脉粥样硬化范围和冠状动脉狭窄程度的临床意义。方法将符合入选标准的140例患者根据检查结果分为4组:冠状动脉性心脏病(冠心病)合并等危症组(39例)、单纯冠心病组(42例),冠心病等危症组(24例)以及对照组(35例)。采用定量的酶联免疫测定法(ELISA法)测定血浆APN浓度,采用RocheElecsys 1010自动分析仪测定血浆NT-proBNP浓度,所得结果进行统计学分析。结果冠心病等危症组、冠心病组和冠心病合并等危症组与对照组比较,血浆APN浓度依次逐步降低,差异有统计学意义[(9.34±0.58)mg/L,(6.59±0.15)mg/L,(3.01±0.22)mg/L比(13.51±0.93)mg/L;F=3.625,P<0.05)。冠心病等危症组、冠心病组和冠心病合并等危症组与对照组比较,血浆NT-proBNP浓度显著升高,差异有统计学意义[(331.93±106.76)pg/mL,(320.82±78.85)pg/mL,(438.58±106.01)pg/mL比(65.60±12.03)pg/mL;F=74.082,P<0.01)。直线相关分析显示,血浆APN浓度与血浆NT-proBNP浓度负相关(r=-0.217,P=0.01);Gensini积分与血浆APN浓度呈负相关(r=-0.522,P<0.001),与血浆NT-proBNP浓度呈正相关(r=0.257,P=0.002)。结论同时测定血浆APN浓度和血浆NT-proBNP浓度有助于更好地预测动脉粥样硬化的范围和反映冠状动脉狭窄的程度。

Objectives To evaluate the prediction of measuring the concentration of adiponectin （APN） and Nterminal pro brain natriuretie peptide （NT-proBNP） in blood plasma in patients with atherosclerosis and coronary artery disease. Methods Classified the 140 patients who corresponded to the selected criterion into 4 groups： coronary artery disease （CAD） with equivalents group （n =39）, CAD group （n =42） , CAD equivalents group （n=24） and control group （n=35）. The concentration of APN in blood plasma was measured by enzyme linked immunosorbent assay （ELISA） and the concentration of NT-proBNP in blood plasma was measured by RoeheElecsys 1010 automatic analysis machine. Results Compared with control group, the concentration of APN in blood plasma in CAD with equivalents group, CAD group and CAD equivalents group decreased gradually and there were significant differences among the 4 groups [ （9.34±0.58） mg/L, （6.59±0.15） mg/L, （3.01±0.22） mg/L vs. （ 13.51±0.93） mg/L; F=3.625, P〈0.051. The concentration of NT-proBNP in blood plasma was higher in CAD with equivalents group, CAD group and CAD equivalent group, as compared with the control group [（331.93±106.76） pg/mL, （320.82±78.85） pg/mL, （438.58±106.01） pg/mLvs. （65.60±12.03） pg/mL; F=74.082, P〈0.01].Linear analysis showed that correlation of the concentration of APN in blood plasma and the concentration of NT-proBNP in blood plasma was negative （r =-0.217, P=0.01）. Correlation of Gensini integrals and the concentration of APN in blood plasma was negative （r=-0.522, P〈0.001 ） , and correlation of Gensini integrals and the concentration of NT-proBNP in blood plasma was positive （r =0.257, P=0.002）. Conclusions Combining examination of the concentrations of APN and NT-proBNP in blood plasma can show severity of coronary artery stenosis and area of atherosclerosis more effectively and exactly.