血浆PCSK9水平与冠状动脉狭窄程度的相关性研究

Correlation between plasma PCSK9 levels and the severity of coronary stenosis

目的：验证血浆前蛋白转化酶枯草杆菌蛋白酶Kexin9型（PCSK9）水平与冠状动脉狭窄程度的相关性。方法：连续入选因心绞痛样胸痛和（或）运动试验阳性接受冠状动脉造影的患者243例,收集基线临床资料,采用ELISA方法检测血浆PCSK9水平。根据标准Gensini积分四分位法将患者分为3组（低分值组0~14,135例;中等分值组25～53,54例;高分值组≥54,54例）,对PCSK9水平与冠状动脉狭窄程度的相关性进行分析。结果：与低分值组相比,高分值组患者PCSK9血浆水平显著升高（208.61、217.43、246.81ng/ml）。血浆PCSK9水平与Gensini积分呈正相关（r=0.191,P=0.003）。经多因素回归分析调整传统危险因素后,证实PCSK9是冠状动脉狭窄程度的独立危险因子（r=0.139,P=0.034）。另外,经非配对检验后发现多支冠状动脉狭窄的患者其PCSK9水平更高（P=0.011）。结论：血浆PCSK9水平与冠状动脉粥样硬化性狭窄的严重程度具有相关性。

Objective：To test the hypothesis that plasma PCSK9 levels may be associated with the severity of coronary stenosis.Method：In this cross-sectional study,we consecutively enrolled 243 patients who had anginalike chest pain and/or positive exercise tests and underwent coronary angiography.Baseline clinical characteristics were collected and plasma PCSK9 levels were determined by ELISA.Patients were classified into three groups according to tertiles of standard Gensini score（low grouP〈0~24,n=135;intermediate group 25~53,n=54;high group ≥54,n=54）.The relationship between PCSK9 levels and the severity of coronary stenosis were evaluated.Result：Patients in high score group had significant elevated PCSK9 concentrations compared with those in low score group（208.61,217.43,246.81ng/ml,respectively）.A positive association between plasma PCSK9 and the Gensini score was found（r=0.191,P=0.003）.In multivariate regression analysis,PCSK9 was demonstrated to be an independent factor of coronary stenosis after adjustment for classical risk factors（r=0.139,P=0.034）.In addition,patients with muti-vessel stenosis tended to have higher PCSK9 levels according to nonparametric test（P=0.011）.Conclusion：Plasma PCSK9 levels are associated with the severity of coronary stenosis in patients with atherosclerosis.