冠心病患者外周血中脂联素和内皮祖细胞水平与斑块活化的关系及瑞舒伐他汀钙干预作用的研究

The correlation between adiponectin and endothelial progenitor cells in patients with cornary heart disease and the effect of rosuvastatin intervence

目的通过测定不同类型冠心病患者外周血中脂联素(APN)及内皮祖细胞(EPCs)的水平,探讨APN及EPCs与斑块活化的关系;并用瑞舒伐他汀钙干预,探索其调脂之外的内皮保护作用。方法选取冠心病患者96例[其中急性冠状动脉综合征(ACS)患者45例,稳定性心绞痛(SAP)患者51例]及健康对照组者24例:ELISA法测定外周血APN的水平;流式细胞术检测外周血中EPCs(CD34+/CD309+)的水平。冠心病患者应用瑞舒伐他汀钙两周后,复查外周血中APN及EPCs水平。结果 (1)ACS患者外周血中APN及EPCs水平均低于SAP患者和健康对照者,差异具有统计学意义(P<0.05);(2)SAP患者外周血中APN及EPCs水平均低于健康对照者,差异具有统计学意义(P<0.05);(3)相关性分析发现研究对象外周血中APN与EPCs水平呈正相关(r=0.865,P<0.01);(4)应用瑞舒伐他汀钙干预后,ACS患者及SAP患者外周血中EPCs水平均较干预前明显升高,差异具有统计学意义(P<0.05)。结论随着斑块不稳定程度的加重,APN及EPCs的水平逐渐下降,提示血管内皮损伤导致功能状态紊乱,可能与心血管疾病发生发展密切相关。

Objective To explore the relationship between adiponectin（APN）/endothelial progenitor cells （EPCs） and atherosclerotic lesion activation in patients with coronary heart disease （CHD）.Methods Ninty six patients with coronary heart disease were included （45 patients with acute coronary syndrome and 51 patients with stable angina pectoris）,and 24 healthy volunteers were admitted as control group.The adiponectin levels were evaluated by ELISA.The level of EPCs was evaluated by flow cytometry assay.The patients with CHD accepted statins treatment for two weeks,and then repeated the former program.Results （1） The level of APN and EPCs in the peripheral blood of ACS group was lower than SAP group and control group.The differences were significant（P 〈0.05） ; （2） The level of APN and EPCs in the peripheral blood of SAP group was lower than control group.The differences were significant（P 〈 0.05） ;（3）A strong correlation was noted between the level of APN and EPCs （r =0.865,P 〈 0.01） ; （4） The level of APN/EPCs was significant increased in patients with ACS and SAP after statins treatment（P 〈 0.05）.Conclusions The level of APN/EPCs decreased according to the advancement of atherosclerotic lesions.It implies that vascular endothelial injury maybe lead to various types of cardiovascular disease.