不同的尿微量蛋白与冠脉病变程度的关系

Association of Different Kinds of Uromicroprotein with Coronary Pathological Change Degree

目的通过检测冠心病患者尿视黄醇结合蛋白（RBP）、尿微量清蛋白（m-Alb）、尿转铁蛋白（TRF）及尿N-乙酰-β-D氨基葡萄糖苷酶（NAG）的含量,评价尿中4种不同微量蛋白与冠脉病变的关系。方法选取2007年3月—2008年3月上海交通大学医学院附属第九人民医院心内科收治的180例患者,入院后均行冠状动脉造影（CAG）,其中135例CAG证实存在冠状动脉狭窄病变者为冠心病组,阴性的45例为非冠心病组。采用酶联免疫吸附法（ELISA）检测各种尿微量蛋白的含量。结果冠心病组和非冠心病组的RBP、m-Alb间差异有统计学意义（P〈0.01）。按CAG结果的Gensini积分方法,积分最低（0~1.0）与积分最高（22.0~）两组的RBP、m-Alb间差异有统计学意义（P〈0.05）。Gensini积分与RBP和NAG均呈正相关,有统计学意义（P〈0.05）。RBP与腰臀比（WHR）、C-反应蛋白（CRP）呈正相关,与高密度脂蛋白胆固醇（HDL-C）呈负相关;m-Alb与WHR、CRP呈正相关,与HDL-C呈负相关;NAG与WHR、CRP呈正相关（P〈0.05）。结论冠心病患者尿微量蛋白含量的增高可能预示着存在冠脉病变;冠脉病变越严重尿微量蛋白含量越多。腹型肥胖者和CRP高者,尿微量蛋白量更高;而HDL-C增高可能是减少尿微量蛋白的一种因素。

Objective To evaluate the association of 4 different kinds of uromicroproteins with the degrees of coronary pathological changes through examining the contents of coronary disease patients＇ urine retinal binding protein（RBP）,urine micro-albumin（m-Alb）,urine transferrin（TRF）,and urinates N-the acetyl-β-D amino grapeglycosidase（NAG）.Methods Totally 180 inpatients presenting from March 2007 to March 2008 in Department of Cardiology,Ninth People＇s Hospital Affiliated to Shanghai Jiaotong University Medical College were recruited.The coronary angiography（CAG） was performed for all the patients after admission.Among them 135 were diagnosed as having coronary stenosis by CAG（CS group）,and 45 had no coronary stenosis（non-CS group）.ELISA was taken to examine the contents of uromicroproteins.Results The contents of RBP and m-Alb showed significant difference between the two groups（P0.01）.According to the CAG result＇s Gensini integral method,the lowest integral（0~1.0） group and the highest integral（22.0~） group had significant difference in contents of RBP and m-Alb（P0.05）.The Gensini integral was positively correlated with the contents of RBP and NAG（P0.05）.The RBP level was correlated positively with the waist to hip ratio（WHR） and C-reactive protein（CRP）,negatively with high density lipoprotein-cholesterol（HDL-C）;the m-Alb level was correlated with WHR and CRP,negatively with HDL-C;and the NAG level was positively correlated with WHR and CRP（P0.05）.Conclusion The increase of uromicroprotein for patients with coronary heart disease may indicate the coronary lesion,and the severer the coronary lesion,the more content the uromicroprotein.The patients with abdominal obesity and high CRP have higher quantity of uromicroprotein;but increase of HDL-C may contribute to reduction of uromicroprotein.