内源分泌型高级糖基化终末产物受体与冠心病危险因素对动脉弹性的影响

The influence of serum endogenous secretory advanced glycation endproducts receptor and CAD risk factors on arterial elasticity

目的探讨冠心病患者内源分泌型高级糖基化终末产物受体(esRAGE)与冠心病危险因素对动脉弹性的影响。方法选择180例冠心病患者,检测颈-股动脉脉搏波传导速度(cf-PWV)、肱-踝动脉脉搏波传导速度(ba-PWV)和血esRAGE,分析与冠心病相关的危险因素。结果与未合并高血压、糖尿病、腰围正常和≤3个异常代谢组分患者比较,合并高血压、糖尿病、腰围异常和>3个异常代谢组分患者的cf-PWV、ba-PWV明显增高,血esRAGE降低(P<0.05)。log cf-PWV与年龄、收缩压、舒张压、稳态模式评估法胰岛素抵抗指数呈正相关,与esRAGE呈负相关(P<0.05)。ba-PWV与年龄、收缩压、舒张压呈正相关,与esRAGE呈负相关(P<0.05)。log cf-PWV与年龄、收缩压、esRAGE独立相关;ba-PWV与年龄、收缩压独立相关。结论合并危险因素的冠心病患者的动脉弹性功能明显减低,冠心病患者esRAGE水平下降在动脉弹性减低方面起着重要作用。

Objective To analyze the influence of serum endogenous secretory advanced glycation end-products receptor（esRAGE） and coronary artery disease（CAD） risk factors on arterial elasticity in patients with CAD. Methods 180 patients with CAD diagnosed by coronary angiography were enrolled. Arterial elasticity parameters（cf-PWV, ba-PWV） and cardiometabolic risk factors were measured in all patients. The relationships of serum esRAGE and cardiometabolic risk factors with arterial elasticity were analyzed. Results Patients with more than 3 types of cardiometa- bolic risk factors had higher cf-PWV, ba-PWV and lower esRAGE than those with less risk factors （P 〈 0.05）. Log cf-PWV was positively correlated to age, blood pressure and log HOMA （insulin resistance index） ; ba-PWV was positively correlated with age and blood pressure. Both cf-PWV and ba-PWV were negatively correlated with esRAGE. Multi-factor regression analysis showed that age, SBP and esRAGE independently correlated with log cf-PWV. Age and SBP were independently correlated with ba-PWV. Conclusion Cardiometabolic risk factors can induce abnormal arterial elasticity. Low circulating esRAGE level plays an important role in the decrease in arterial elasticity in patient with CAD.