血清脂联素水平与冠心病严重程度的相关性分析

Correlation between serum adiponeetin level and severity of coronary artery lesion

目的探讨血清脂联素（APN）水平与冠心病及其病变严重程度的相关性。方法选取112例行冠状动脉造影的患者，临床诊断为急性冠状动脉综合征（ACS）患者58例（ACS组）、稳定型心绞痛患者25例（稳定型心绞痛组）、非冠心病患者29例（对照组），进行血清APN测定，冠状动脉病变程度用冠状动脉病变支数及Gensini积分表示，按病变范围分为单支病变组（24例）、双支病变组（26例）、三支病变组（33例）；按Gensini积分分为0～1分组（29例）、2～20分组（28例）、21—40分组（30例）、〉40分组（25例）。结果ACS组血清APN水平显著低于对照组和稳定型心绞痛组[（6．43±4．22）mg／L比（12．68±6．47）、（9．94-I-8．48）mg／L]（P〈0．01或〈0．05）。对照组血清APN水平显著高于单支病变组、双支病变组和三支病变组[（12．68±6．47）mg／L比（8．80±6．23）、（8．04±5．93）、（6．43±5．12）mg／L]（P〈0．01），单支病变组血清APN水平显著高于三支病变组（P〈0．01）。0～1分组血清APN水平[（12．68±6．47）mg／L]和2～20分组血清APN水平[（8．74±6．68）mg/L]分别显著高于2l一40分组[（7．64±5．32）mg／L]和〉40分组[（6．32±5．46）mg／L]（P〈0．01）。21～40分组血清APN水平高于〉40分组（P〈0．05）。血清APN水平与Gensini积分的对数呈负相关（r=-0．584，P〈0．01）。结论APN与冠状动脉稳定性、狭窄程度以及范围显著相关，有助于临床评价冠心病病变程度及其进展。

Objective To investigate the correlation between serum adiponeetin level and severity of coronary artery lesion. Methods The serum concentrations of adiponectin in 112 patients whom bad received coronary arteriongraphy （CAG） were measured. Among them,58 cases had acute corolaary artery syndromes （ACS） （ ACS group）, 25 cases had stable angina cordis （stable angina cordis group） and 29 cases had non-coronary disease （control group ）. The severity of coronary artery lesion was evaluated by the number of stenosis vessel and Gensini score. All the patients were divided into single vessel lesion group （ 24 cases ）, double-vessel lesion group （26 cases）, triple-vessel lesion group （ 33 cases ） by extent of disease; and 0-1 score group （29 cases）,2-20 scores group （28 cases）,21-40 scores group （30 cases）, 〉 40 scores group （25 cases） by Gensini score. Results The serum concentrations of adiponectin in ACS group were lower than those in control group and stable angina cordis group [ （6.43 ± 4.22 ） mg/L vs. （ 12.68 ± 6.47 ）, （9.94 ±8.48 ） mg/L ] （P 〈 0.01 or 〈 0.05 ）. The serum concentrations of adiponectin in control group were higher than those in single vessel lesion group, double-vessel lesion group and triple-vessel lesion group [ （ 12.68 ± 6.47 ） mg/L vs. （8.80 ±6.23）, （8.04 ±5.93）, （6.43 ±5.12） mg/L] （P 〈0.01）. The serum concentrations of adiponectin in single vessel lesion group were higher than those in triple-vessel lesion group （P 〈 0.01 ）. The serum concentrations of adiponectin in 0-1 score group I （12.68 ± 6.47） mg/L] and 2-20 scores group [ （ 8.74± 6.68 ） mg/L ] were respectively higher than those in 21-40 scores group [ （7.64 ± 5.32 ） mg/L ] and 〉 40 scores group [ （6.32 ± 5.46） mg/L] （P 〈 0.01 ）. The serum concentrations of adiponectin in 21-40 scores group were higher than those in 〉 40 scores group（P〈 0.05 ）. The serum concentrations of adiponeetin were negatively correlated with the log of Gensini score （r = -0.584,P 〈 0.01 ）. Conclusion The decrease in serum adiponeetin might reflect the increase in severity of coronary artery lesion.