急性冠状动脉综合征患者血清脂联素及高分子量脂联素浓度与罪犯病变虚拟组织学-血管内超声的特点

Plasma total adiponectin,high molecularweight adiponectin and the VH-IVUS characters of culprit lesions in acute coronary syndrome patients

目的:探讨血清脂联素及高分子量脂联素浓度随冠状动脉(冠脉)粥样硬化性斑块构成变化而变化的现象,为进一步研究影响冠脉斑块易损性的机制提供依据。方法:选取急性冠脉综合征(ACS)患者60例,运用酶联免疫分析法(ELISA)检测血清脂联素及高分子量脂联素的浓度。结合ST段及T波发生改变的导联,室壁运动异常的节段,复杂病变的部位及斑块破裂与否来综合确定罪犯病变。研究ACS患者血清脂联素及高分子量脂联素浓度与罪犯病变罪犯病变虚拟组织学-血管内超声(VH-IVUS)特点的相关性。结果:ACS患者血清高分子量脂联素与罪犯病变纤维脂质体积绝对值呈中等程度相关(r=0.505,P<0.01),与罪犯病变纤维组织体积绝对值亦呈正相关(r=0.499,P<0.01),而ACS患者血清脂联素与罪犯病变4种VH-IVUS检测的成分间无相关性。结论:ACS患者罪犯病变斑块相对稳定的成分纤维组织和纤维脂质含量增加时,血清高分子量脂联素也增加。高分子量脂联素作为保护性的脂肪因子可能参与到影响冠脉斑块易损性的机制。

Objective：To analyse the relationship between plasma adiponectin, high molecular weight adiponectin （HMW-adiponectin） and the VH-IVUS characters of culprit lesions in acute coronary syndrome （ACS） pa- tients, in order to know how plasma adiponectin and HMW-adiponectin change with different constitution of thecoronary plaque. Method： Sixty ACS patients were included in our study. We used ELISA to analyse total adipone- ctin and HMW-adiponectin. Culprit lesion were identified by analyzing ST-T alternation on electrocardiograms,left ventricular wall motion abnormalities, angiographic complex lesions and IVUS-detected plaque rupture. We per- formed VH-IVUS examination on each culprit lesion and analyzed the relationship between total adiponectin, HMW-adiponectin and the VH-IVUS characters of the culprit leisions. Result：Plasma HMW-adiponectin was pos- itively associated with the absolute volume of fibro-fatty （r=0. 505, P〈0. 01） and fiber （r=0. 499, P〈0. 01）, however there was no relationship between adiponectin and any component of culprit lesion in ACS patients. Con- clusion：While the plasma H MW-adiponectin rises, the relative stable volume （fibro-fatty and fiber） is growing in ACS patients. As the protective adipocytokines, HMW-adiponectin might influence the plaque vulnerability.