急性冠状动脉综合征患者血浆脑肠肽、肥胖抑制素水平变化及意义

Changes in levels of ghrelin and obestatin in plasma of patients with acute coronary syndrome and the significance

目的观察急性冠状动脉综合征(ACS)患者血浆脑肠肽、肥胖抑制素水平变化,并探讨其临床意义。方法研究对象为108例ACS患者(A组)、30例健康体检者(B组),采用放射免疫法检测两组血浆脑肠肽、肥胖抑制素的水平,并分析其与ACS危险因素的相关性。结果 A组BMI、LDL、血压、颈动脉内中膜厚度(IMT)、颈动脉斑块所占比例明显高于B组(P均<0.05),血糖水平升高但差异无统计学意义。与B组比较,A组血浆脑肠肽水平降低、肥胖抑制素水平升高(P均<0.05),血浆脑肠肽/肥胖抑制素比值降低(P<0.05)。相关性分析显示,A组血浆脑肠肽水平与BMI、IMT、LDL呈负相关(r分别为-0.17、-0.31、-0.22,P均<0.05);血浆肥胖抑制素水平与IMT、LDL呈正相关(r分别为0.29、0.24,P均<0.05)。结论 ACS患者血浆脑肠肽水平降低、肥胖抑制素水平升高,二者可能参与了ACS的发生、发展。

Objective To investigate the mechanism and significance of ghrelin and obestatin in the occurrence and development of acute coronary syndrome （ACS）.Methods A total of 108 ACS patients （group A） and 30 healthy peo-ple（group B） were selected.The levels of ghrelin and obestatin in plasma were detected by radioimmunoassay , and the correlations of ghrelin and obestatin levels with the risk factors of ACS were analyzed .Results Compared with group B , the body mass index（BMI）,low density lipoprotein （LDL）, blood pressure, intima-media thickness（IMT）and the propor-tion of carotid plaques were significantly higher in the group A （P〈0.05）, the blood glucose levels increased , but it was not statistically significant .The ghrelin level was significantly lower and the obestatin level was significantly higher in the group A as compared with those of group B （all P〈0.05）.The G/O ratio of the group A was significantly lower than that of group B （P〈0.05）.Correlation analysis showed that the level of ghrelin in plasma was negatively correlated with BMI , LDL and IMT （r=-0.17,-0.31 and -0.22;all P〈0.05）;the level of obestatin in plasma was positively correlated with LDL and IMT（r=0.29, 0.24;all P〈0.05）.Conclusions The expression of plasma ghrelin and obestatin was ab-normal in ACS patients , which may participate in the occurrence and development of atherosclerosis .