冠心病患者血清生长分化因子15C反应蛋白水平与冠状动脉病变程度的相关性分析

A relation analysis between serum levels of differentiation factor 15 and C reactive protein in patients with different coronary heart diseases and the correlation with severity of coronary artery lesion

目的探讨不同类型冠心病患者的血清生长分化因子15(GDF-15)、C反应蛋白(CRP)的水平变化,与粥样硬化斑块稳定性和冠状动脉病变程度的关系。方法选择行冠状动脉造影检查的冠心病患者92例作为研究对象,根据冠状动脉造影结果及临床病史,分为22例稳定型心绞痛组(A组),25例不稳定型冠心病组(B组),25例心肌梗塞组(C组)及20例正常对比组(D组),每组均测量并比较血清中GDF-15、CRP水平,并且采用Gensini积分评定冠状动脉血管病变狭窄程度与GDF-15、CRP的相关性。结果 A组、B组、C组血清GDF-15水平均明显高于D组(P<0.05),B组血清GDF-15、CRP水平均明显高于A组、D组(P<0.05),C组血清GDF-15、CRP水平均明显高于A、B、D组(P<0.05);血清GDF-15、CRP水平和冠状动脉病变Gensini积分均有正相关性(P<0.05)。结论 GDF-15和CRP水平与冠状动脉粥样硬化斑块的不稳定性及冠状动脉病变程度有关,斑块越不稳定,病变越重、GDF-15和CRP水平越高,对判断冠心病患者的病情程度、发展和预后有重要作用。

Objective To investigate the change of serum levels of growth differentiation factor 15 （GDF - 15） and C reactive pro- tein （CRP） in patients with different coronary heart diseases（ CHD）, and its relationship with the stability of atherosclerotic plaque and se- verity of coronary artery lesions. Methods Ninety - two patients undergoing coronary angiography were included in the study. According tothe coronary angiographic results and clinical history, the patients were divided into stable angina pectoris group （group A, n = 22 ）, unstable angina pectoris group（ group B ,n = 25）, acute myocardial infarction group（ group C, n = 25 ） and normal control group（ group D, n = 20）. Seium levels of GDF - 15 and CRP were determined and compared among different groups. The degree of coronary artery stenosis was assessed by Gensini score,and the correlation between serum levels of GDF - 15, CRP and Gensini score was analyzed. Results The serum levels of GDF - 15 in group A, B and C was significantly higher than that of group D （P 〈 0.05 ）. The serum levels of GDF - 15 and CRP in group B were significantly higher than those of group A and D （P 〈0.05 ）. The serum levels of GDF - 15 and CRP in group C were significantly high- er than those of group A, B and D （ P 〈 0.05 ）. The serum level of GDF - 15 and CRP was positively correlated with Gensini score（P 〈 0. 05 ）. Conclusion The serum levels of GI）F - 15 and CRP are correlated with the instability of atherosclerotic plaque and degree of coronary artery lesion. Patients with instable atherosclerotic plaque and serious coronary artery lesion have a higher level of GDF - 15 and CRP, which play an important role in judging the severity and prognosis in patients with coronary heart diseases.