不同糖耐量水平稳定型心绞痛患者高敏C反应蛋白水平与内皮功能的相关性

Related Research of High Sensitivity C-Reactive Protein Levels and Endothelial Function in Different Glucose Tolerance Level of Patients with Stable Angina Pectoris

目的观察不同糖耐量水平稳定型心绞痛患者高敏C反应蛋白、可溶性细胞间黏附分子1和可溶性血管细胞黏附分子1水平及肱动脉内皮功能,同时分析患者高敏C反应蛋白水平与可溶性细胞间黏附分子1水平、可溶性血管细胞黏附分子1水平及肱动脉内皮功能之间的相关性。方法选取60例经冠状动脉造影证实为稳定型心绞痛患者,根据口服葡萄糖耐量试验分为糖耐量正常组、糖耐量减退组和2型糖尿病组,每组20例患者。采用酶联免疫吸附法检测不同糖耐量水平稳定型心绞痛患者血清高敏C反应蛋白、可溶性细胞间黏附分子1和可溶性血管细胞黏附分子1水平。同时采用超声心动图检测不同糖耐量水平稳定型心绞痛患者肱动脉内皮依赖性血流量介导的扩张反应。结果糖耐量正常组、糖耐量减退组和2型糖尿病组血清高敏C反应蛋白水平分别为1.03±0.32 mg/L、2.14±0.82 mg/L及3.05±1.56 mg/L,其中糖耐量正常组和2型糖尿病组比较有统计学差异(P<0.05)。糖耐量正常组、糖耐量减退组和2型糖尿病组血清可溶性细胞间黏附分子1水平分别为112.76±32.03μg/L、175.37±41.21μg/L及234.21±56.14μg/L;可溶性血管细胞黏附分子1水平分别为214.04±92.34μg/L、314.56±101.69μg/L及485.89±173.24μg/L,糖耐量正常组和2型糖尿病组比较有统计学差异(P<0.05)。糖耐量正常组、糖耐量减退组和2型糖尿病组肱动脉内皮依赖性血流量介导的扩张反应分别为5.87%±2.52%、4.06%±2.02%及2.03%±0.98%,各组比较有统计学差异(P<0.05)。校正了性别、年龄、吸烟史、体质指数、血脂和血压等因素影响后,高敏C反应蛋白水平与内皮功能相关(P<0.05)。结论稳定型心绞痛患者随着糖耐量的减退其内皮功能逐渐减退,而高敏C反应蛋白的水平逐渐升高,高敏C反应蛋白水平与其内皮功能显著相关。

Aim To observe high sensitivity C-reactive protein （hs-CRP）, soluble intercellular adhesion molecule-1 （slCAM-1）, soluble vascular cell adhesion molecule-1 （sVCAM-1） and brachial artery endothehal function in different glucose tolerance level of patients with stable angina pectoris （ SAP）, and analyze the correlation of hs-CRP, sICAM- 1, sVCAM-1 and brachial artery endothelial function. Methods Sixty SAP patients who confirmed by coronary angiography were selected. By OGTI＇, the sixty patients were divided into three groups ： normal glucose tolerance （NGT） group, impaired glucose tolerance （IGT） group and type 2 diabetes （T2DM） group, 20 patients in each group. Hs- CRP, slCAM and sVCAM levels were detected by enzyme linked immunosorbent assay. The flow-mediated dilation （FMD） in the brachial artery were detected by high-resolution ultrasound. Results The levels of hs-CRP in NGT group, IGT group and T2DM group were respectively 1.03 ± 0. 32 mg./L, 2. 14 ± 0. 82 mg/L and 3.05 ±1.56 rag/L, there was statistic difference between NGT group and T2DM group （P 〈 0.05）. The levels of sICAM-1 in NGT group, IGT group and T2DM group were respectively 112. 76 ±32. 03 p,g/L, 175.37 ±41.21 μg/L and 234. 21 ±56. 14 μg/L, the levels of sVCAM-1 in NGT group, IGT group and T2DM group were respectively 214. 04 ±92. 34 μg/L, 314. 56 ±101.69 μg/L and 485.89 ±173.24 μg/L, there was statistic difference between NGT group and T2DM group. The FMD in NGT group, IGT group and T2DM group were respectively 5. 87% ± 2. 52% , 4. 06%±2. 02% and 2.03% ± 0. 98% , there were statistic differentce between each groups （ P 〈 0. 05 ）. After correcting effection of gender, age, smoking, BMI, blood lipids and blood pressure, the closed relation was found between hs-CRP and endothelial function （ P 〈 0. 05 ）. Conclusions The endothelial function of SAP patients was decreased with the decrement of carbohydrate tolerance, while the hs-CRP level was increased. The hs-CRP level is significantly correlated with endothelial function.