冠状动脉扩张程度与循环炎性因子和血胰岛素水平的关系

The correlation analysis of serum levels inflammatory factors and insulin to the degree of coronary artery ectasia

目的探讨循环炎性因子可溶性E选择素(sES)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制物-1(TIMP-1)以及血胰岛素水平与冠状动脉扩张(CAE)程度的相关性及临床价值。方法选择106例接受冠脉造影患者,依据造影结果差异分为:对照组(n=38,冠脉正常),扩张组(n=32,冠脉扩张),狭窄组(n=36,冠脉狭窄)。检测并比较住院期间3组患者血清的sES、MMP-9、TIMP-1及血胰岛素水平的差异。应用Pearson直线分析上述指标与CAE程度的相关性,多元Logistic回归分析与CAE发生的危险因素。结果扩张组的sES及MMP-9水平最高(P<0.05),狭窄组次之,对照组最低(P<0.05);扩张组的血胰岛素水平最低,对照组次之,狭窄组最高(P<0.05);三组TIMP-1水平差异无统计学意义(P>0.05)。Pearson直线分析显示sES及MMP-9水平与CAE程度呈正相关性(r=0.613,P=0.032;r=0.671,P=0.027),与血胰岛素水平呈负相关性(r=-0.754,P=0.023),与TIMP-1水平则无相关性(r=0.128,P=0.105)。多元Logistic回归分析显示,sES及MMP-9为CAE的危险因素,而高胰岛素血症为保护性因素。结论循环炎性因子sES、MMP-9以及血胰岛素水平能较好地评估患者发生冠脉扩张的危险性。

Objective To analyze the correlation and clinical value of serum levels of soluble E selectin （sES）, matrix metalloproteinase-9 （ MMP-9）, tissue inhibitor of metalloproteinase-1 （ TIMP-1 ） and insulin to the degree of coronary artery ectasia （CAE）. Methods The 106 in-patients received with coronary angiography （CAG） were collected and divided into three groups according to the CAG outcome, which were control group （38 cases, normal coronary artery）, ectasia group （32 cases, coronary artery ectasia） and stenosis group （36 cases, coronary artery stenosis）. The serum levels of sES, MMP-9, TIMP-1 and insulin were detected and compared among three groups during admission. The relative factors to the degree of CAE were confirmed by Pearson linear analysis. And the risk factors to the occurrence of CAE were confirmed by multivariate Logistic analysis. Results The serum levels of sES and MMP-9 of ectasia group were highest （P 〈 0. 05 ）, and the stenosis group was mediate and the control group was lowest （ P 〈 0. 05 ）. The serum level of insulin of ectasia group were lowest （ P 〈 0. 05 ）, and the normal group was mediate and the stenosis group was highest （ P 〈 0. 05）. But the serum levels of TIMP-1 have no differ- ence among three groups. The positive relationship of the serum levels of sES, MMP-9 to the degree of CAE was confirmed by Pearson linear analysis （r =0. 613, P =0. 032; r =0. 671, P =0. 027）. And the negative relation- ships of the serum levels of insulin to the degree of CAE were also confirmed （ r = - 0. 754, P = 0. 023 ）. But there was no relationship of the serum levels of TIMP-1 to the degree of CAE （r = 0. 128, P = 0. 105 ）. Multivariant Lo- gistic analysis showed that the sES and MMP-9 were risk factors to the occurrence of CAE and the hyperinsulinemia was the protective factor to the occurrence of CAE. Conclusion Serum levels of sES, MMP-9 and insulin can as- sess the risk of CAE.