血清脂联素水平与冠脉病变严重程度有关

Relationship between serum adiponectin concentration and severity of coronary artery lesions

目的:了解血清脂联素水平与冠脉病变严重程度的关系。方法:入选96例冠状动脉造影(CAG)的冠心病患者,根据临床病史和CAG结果分为2组:急性冠脉综合征(ACS)组60例,稳定型心绞痛(SAP)组36例;另收集非冠心病CAG阴性组40例为对照组。用Gensini评分系统对冠状动脉病变程度进行评分。根据Gensini评分系统将冠脉病变组分为Gensini积分≥30分组和<30分组,再根据冠脉病变支数分为单支,双支和3支组。采用双抗体夹心ELISA法测定血清脂联素水平。分析血清脂联素水平与冠脉病变严重程度及冠脉病变支数的相互关系。结果:ACS组和SAP组血清脂联素水平[(7.2±2.6)mg/L,(8.4±3.2)mg/L]明显低于非冠心病组[(19.5±2.5)mg/L,均P<0.01],且ACS组和SAP组之间差异也具有统计学意义(P<0.05)。Gensini积分≥30分脂联素水平[(7.0±1.6)mg/L]明显低于<30分组,[(13.7±6.7)mg/L,P<0.01]。3支病变组血清脂联素水平[(7.5±2.8)mg/L]较单支组[(13.2±5.8)mg/L]显著降低(P<0.01),较双支病变组[(10.7±4.8)mg/L]也显著降低(P<0.05)。双支病变组与单支病变组之间差异无统计学意义。血清脂联素水平与冠脉病变严重程度Gensini积分呈负相关(r=-0.713,P<0.01)。结论:脂联素水平与冠脉病变严重程度及冠脉病变支数显著相关,低脂联素水平可以作为评价冠脉病变严重程度的一个指标。

AIM： To explore the relationship between serum adiponeetin concentration and the severity of coronary artery lesions. METHODS： One hundred and thrity six coronary heart disease （CHD） patients identified by coronary angiography were recruited in this study. Patients were divided into three groups according to their coronary angiographic characteristics and clinical histories： 60 acute coronary syndrome patients, 36 stable angina patients and 40 negative control patients. According to the modified Gensini scores, the CHD patients were subdivided into Gensini score ≥30 group and 〈 30 group and further divided by single-, double- or triple-vessel coronary lesions. Serum adiponectin concentrations of the subjects were measured by double-antibody sandwich ELISA method. RESULTS： Serum adiponectin concentrations in the CHD group （ACS and SAP） [（7.2 ±2.6） mg/L, （8.4±3.2） mg/L] were significantly lower than those in the control group [ （ 19.5 ± 2.5 ） mg/L, P 〈 0.01 ]. Adiponectin concentration increased with the development of atherosclerosis. The adiponectin level of Gensini score 30 was lower than that of Gensiniscore 〈30 [（7.0±1.6） mg/L vs. （13.7±6.7） mg/L, P〈0.01]. A significant difference in serum adiponectin concentrations was observed between patients with triple-vessel and single-vessel lesions [ （7.5 ±2. 8） mg/L vs. （ 13.2 ±5.8） mg/L, P 〈0. 01 ] and between patients with triple-vessel and double coronary lesions [ （7. 5 ± 2. 8 ） mg/L vs. （ 10. 7± 4. 8 ） rag/L, P 〈 0. 05 ]. However, no significant difference was observed in serum adiponectin concentrations between patients with double and single coronary lesions. CONCLUSION： Adiponectin concentration is significantly correlated with the severity of coronary artery lesion and the number of stenosed coronary vessels. Serum adiponectin concentration level can be used as an indicator for evaluating the severity of coronary artery lesions.