冠心病患者血清瘦素水平与冠状动脉狭窄程度的相关性研究

Correlation study between the level of serum leptin and the degree of coronary stenosis in patients with coronary artery disease

目的 探讨冠心病患者血清瘦素水平与冠状动脉狭窄程度的相关性.方法 选择经冠状动脉造影证实的稳定型心绞痛住院患者20例（稳定型心绞痛组）、不稳定型心绞痛住院患者26例（不稳定型心绞痛组）,测定血清瘦素水平,并与20例虽有类似心绞痛症状,但经冠状动脉造影检查未见冠状动脉病变者（对照组）进行比较,分析血清瘦素水平与冠状动脉狭窄程度之间的关系.结果 不稳定型心绞痛组血清瘦素水平[（10.39±8.09）μg/L]显著高于稳定型心绞痛组[（7.65±4.46）μgL]及对照组[（3.93±2.66）μg/L]（P〈0.01）,稳定型心绞痛组与对照组血清瘦素水平比较差异也有统计学意义（P〈0.01）.在冠心病患者中,冠状动脉TIMI分级越低,血清瘦素水平越高,但TIMI分级同一水平时,稳定型心绞痛组和不稳定型心绞痛组血清瘦素水平比较差异无统计学意义（P〉0.05）.不稳定型心绞痛组血清瘦素水平与Gensini积分及TIMI分级呈显著正相关（r值分别为0.654、0.542,P〈0.05）;稳定型心绞痛组血清瘦素水平与Gensini积分及TIMI分级也呈显著正相关（r值分别为0.466、0.518,P〈0.05）.结论 稳定型心绞痛和不稳定型心绞痛患者血清瘦素水平明显升高,且不稳定型心绞痛患者较稳定型心绞痛患者血清瘦素水平高.血清瘦素水平与冠状动脉病变严重程度呈正相关,与冠心病心肌缺血的范围、病变支数、冠状动脉末稍血流情况呈正相关.

Objective To study the relationship between the level of serum leptin and the degree of coronary stenosis in patients with coronary artery disease and evaluate their correlations. Methods Twenty patients with stable angina pectoris （stable angina pectoris group ）, 26 patients with unstable angina pectoris （unstable angina pectoris group ）, and 20 patients with symptom of angina pectoris but without coronary artery disease （control group） were involved in this study, all of whom were diagnosed by coronary arteriography.The levels of serum leptin in the three groups were detected. Results The level of serum leptin in unstable angina pectoris group [（10.39 ± 8.09） μg/L] was significantly higher than that in stable angina pectoris group [（7.65 ±4.46） μg/L] and control group[（3.93 ±2.66） μg/L]（P〈 0.01）. In stable angina pectoris group and unstable angina pectoris group, the lower the angiography TIMI grading, the higher the level of serum leptin. But in the same angiography TIMI grading,the level of serum leptin in two groups had no significant difference. The level of serum leptin in unstable angina pectoris group and stable angina pectoris group had positive correlation with Gensini scores and angiography TIMI grading （r = 0.654,0.542, P 〈 0.05;r = 0.466,0.518, P 〈 0.05 ）. Conclusions The level of serum leptin is significantly higher in coronary artery disease patients and especially in unstable angina pectoris patients. The level of serum leptin has positive correlation with the degree of coronary disease, the extent of myocardial ischemia, the quantity of stenosis and blood stream of coronary artery.