冠状动脉病变程度与血清胱抑素、一氧化氮及超氧化物歧化酶水平的相关性研究

Study on the Relationship between Severity of Coronary Artery Lesion and the Level Cystatin C, Nitric Oxide and Superoxide Dismutase of Serum

目的：通过检测冠状动脉病变患者的血清胱抑素（cystatin C，CyC）、一氧化氮（nitric oxide，NO）及超氧化物歧化酶（superoxide dismutase，SOD）水平，探讨三者与冠状动脉粥样硬化程度的相互关系，从而评价三者对冠心病的临床诊断价值。方法经冠状动脉造影证实冠状动脉没有明显狭窄入选造影正常组，共40例；有一支血管狭窄入选单支病变组，共44例；有两支血管狭窄入选双支病变组，共43例；有大于两支血管狭窄入选多支病变组，共35例。对四组分别进行血清CyC，NO，SOD及超敏C反应蛋白（high-sensitivity C-reactive protein，hs-CRP）水平检测。结果造影正常组、单支病变组、双支病变组、多支病变组的CyC和hs-CRP水平依次呈递增趋势；NO和SOD浓度水平依次呈递减趋势，四组之间差异有统计学意义（P＜0．05）。冠状动脉 Gensini积分与血清CyC和 hs-CRP水平呈正相关，相关系数分别为0.473，0.429；与NO和 SOD水平呈负相关，相关系数分别为-0.356，-0.384。血清CyC与 hs-CRP水平呈正相关，与 NO和 SOD水平呈负相关，相关系数分别为0.458，-0，426，-0.484（P＜0.05）。结论随着冠状动脉病变程度的增加，CyC浓度升高，NO和 SOD减少，引起血管内皮功能障碍，导致冠状动脉发生病变及加重。CyC，NO和 SOD可作为冠心病的辅助诊断指标。

Objective To study the correlation between coronary lesion and Cystatin C （CyC）,Nitric Oxide （NO）and Super oxide dismutase,accumulate the clinical experience in prevention and diagnose of Coronary Heart Disease （CHD）by analyzing the contents of serum Cystatin C （CyC）,Nitric Oxide and Superoxide Dismutase in patients with coronary lesion.Meth-ods According to their severity of coronary artery lesion,all cases were divided into four groups：Normal compared group （40 cases）;Simple branch pathological group （44 cases）;Double branch pathological group （43 cases）：Multi-branch patho-logical group （35 cases）.All cases were tested CyC,NO,SOD and hs-CRP in serum.Results The level of CyC and hs-CRP were increased gradually from normal group to multi-branch group.The level of NO and SOD were decreased gradually from normal group to multi-branch group.There were significant differences the levels of CyC,NO,SOD and hs-CRP among the four groups.Coronary lesion Gensini in the CHD patients had significant positive relationship to the level of CyC or hs-CRP respectively （r=0.473,0.429）,had significant negative relationship to the level of NO or SOD respectively （r=-0.356, 0.384）（P〈0.05）.CyC in the CHD patients had significant positive relationship to the level of hs-CRP （r=0.458）,had sig-nificant negative relationship to the level of NO or SOD respectively （r=-0.426,0.484,P〈0.05）.Conclusion By aggravation of coronary artery lesion,the level of CyC increased,reduced the contents of NO,SOD,aroused endothelial dysfunc-tion,induced occurrence and aggravation of coronary artery lesion.CyC,NO and SOD play important mark in the assistant diagnosis of the disease.