YKL-40和超敏C反应蛋白与冠心病的相关性

Correlation of YKL-40 and hsCRP with coronary artery disease

目的研究超敏C反应蛋白(hsCRP)和YKL-40与冠状动脉病变程度的关系。方法采用Judkins法进行冠状动脉造影,确诊冠心病259例及冠状动脉造影结果正常的对照组251例。应用酶联免疫法测定hsCRP和YKL-40浓度。冠状动脉病变分为1支病变(123例),2支病变(68例)和3支病变组(68例)。采用病例对照的方法进行研究。结果 YKL-40对冠心病易感性预测的受试者特征工作曲线(ROC)下面积(AUC)为0.671[95%可信区间(CI)为1.00-1.02;P<0.01];hsCRP对冠心病易感性预测的AUC为0.778(95%CI为1.24-1.50;P<0.01)。冠心病3支血管病变组血浆hsCRP和YKL-40水平明显高于1支、2支血管病变组(P<0.05或P<0.01);3支血管病变组血浆YKL-40水平明显高于2支血管病变组(P<0.05),而hsCRP在该两组间未见明显差异。在对体重指数(BMI)、高血压史、糖尿病史、吸烟史、高脂血症、TC、LDL-C、hsCRP和YKL-40调整后发现,hsCRP、YKL-40是冠心病最显著的独立相关危险因素(OR=1.37,95%CI为1.24-1.50,P<0.01;OR=1.01,95%CI为1.00-1.02,P<0.01)。结论 hsCRP、YKL-40与冠心病之间有显著相关性。

Objective To investigate whether the plasma high sensitive C-reactive protein （hsCRP） and YKL-40 levels were correlated with the susceptibility and severity of coronary atherosclerosis. Methods Plasma YKL-40 and hsCRP were measured by enzyme-linked immunosorbent assay in 259 cases with coronary artertery disease（CAD） and 251 cases without CAD, who were diagnosed by coronary angiography. CAD patients were assgined to three groups of A（123 cases with 1-vessel stenosis）, B（68 cases with 2-vessel stenosis） and C（68 cases with 3-vessei stenosis）. Results In predicting the susceptibility for CAD, the AUC of YKL-40 was 0. 671（95% CI ：1.00-1.02,P〈0. 01） ,which of hsCRP was 0. 778（95%CI：1.24-1.50,P〈0. 01）. Plasma levels of YKL-40 and hsCRP were higher in group C than those in groups of A and B（P〈0. 05 and P〈0. 01）. Plasma YKL-40,but not hsCRP, was higher in group C than that in group B（P〈0. 05）. After full adjustment of hypertension, diabetes, smoking, hypereholesterolemia, TC and LDL-C, YKL-40 and hsCRP were two independent risk factors for CAD（OR= 1.37,95 % CI： 1.24-1.50, P〈0. 01 and OR = 1.01,95 % CI= 1.00-1.02, P〈0. 01）. Conclusion It is concluded that there is a close relationship between plasma levels of YKL-40 and hsCRP and the severity of CAD.