冠心病患者血浆人类软骨糖蛋白-39、同型半胱氨酸、高敏C反应蛋白水平的变化及其与冠状动脉病变程度的关系

The relationgship between plasma levels of human cartilage glycoprotein-39,homocysteine or high-sensitivity C-reactive protein and coronary artery lesion in patients with coronary heart disease

目的探讨不同类型冠心病患者血浆人类软骨糖蛋白-39(YKL-40)、同型半胱氨酸(Hcy)、高敏C反应蛋白(hsCRP)的变化及其与冠状动脉斑块的稳定性、冠状动脉病变程度的相关性。方法依据临床表现、冠脉造影检查确定入选对象并分为4组:急性心肌梗死组(AMI)、不稳定型心绞痛组(UAP)、稳定型心绞痛组(SAP)和冠脉造影正常的患者为对照组。共99例。依据Gensini积分分为对照组、Gensini积分<30分组,30～60分组,≥60分组。采用酶联免疫法检测各组患者血浆YKL-40、Hcy、hsCRP水平,分析各组患者血浆YKL-40、Hcy、hsCRP水平的差异及其与Gensini积分相关性。结果与对照组相比,冠心病不同临床类型组血浆YKL-40、Hcy及hsCRP水平明显升高(P<0.01),血浆YKL-40、Hcy、hsCRP水平在AMI组、UAP组、SAP组依次降低;且随着Gensini积分升高,血浆YKL-40、Hcy及hsCRP水平逐渐升高(P<0.05),两者呈正相关。结论血浆YKL-40、Hcy、hsCRP水平与冠状动脉病变程度和动脉粥样硬化斑块的不稳定性相关,病变越重、斑块越不稳定,血浆YKL-40、Hcy、hsCRP水平越高。

Objective To explore the relationship between plasma levels of Human cartilage glycoprotein-39,Homocysteine or high-sensitivity C-reactive protein and clinical phenotypes of coronary heart disease（CHD）and stability of atherosclerotic plaque and severity of coronary artery lesions.Methods 99 cases were recruited in this study according to clinical manifestations and diagnostic coronary angiography,and divided into 4 groups：34 cases of acute myocardial infarction（AMI）,20 cases of unstable angina pectoris（UAP）,17 cases of stable angina pectoris（SAP）and 28 cases of the control group.Then they were divided into 4 groups according to Gensini score：Gensini score30,30-60,≥60 and the control group.The plasma levels of human cartilage glycoprotein-39,homocysteine or high-sensitivity C-reactive protein were detected by Enzyme link immunosorbent assay（ELISA）.Results The levels of HC-gp39,Hcy or hs CRP were significantly higher in CHD than those in control（P0.01）.The levels of HC-gp39,Hcy or hs CRP decreased in turn in AMI,UAP and SAP group.As Gensini score raised,the plasma levels of human cartilage glycoprotein-39,homocysteine or high-sensitivity C-reactive protein increased,there was a positive correlation between them.Conclusion The plasma levels of human cartilage glycoprotein-39,homocysteine or high-sensitivity C-reactive protein are associated with the severity of coronary artery lesions and atherosclerotic plaque instability.