血浆Chemerin水平与冠心病患者冠脉病变稳定性及病变程度关系

Relationship between plasma chemerin level and stability of lesions,severity of coronary stenosis in patients with coronary heart disease

目的探讨血浆Chemerin水平与冠心病患者病变稳定性及病变程度的关系。方法选取2014年4月至2015年1月于邢台市第三医院心内科住院并行冠脉造影检查确诊的冠心病患者104例,分为不稳定型心绞痛组(n=60)和稳定型心绞痛组(n=44);同期选取40例冠脉造影正常者作为对照组。根据冠脉造影结果 ,将冠心病患者分为单支、双支及三支病变组,并根据冠脉造影结果进行冠状动脉狭窄程度的Gensini记分评估。采用酶联免疫法测定血浆Chemerin水平。结果不稳定型心绞痛组Chemerin水平显著高于稳定型心绞痛组、对照组,差异均有统计学意义(P<0.05)。单支病变组、双支病变组及三支病变组Chemerin水平显著高于正常对照组,差异有统计学意义;三支病变组Chemerin水平显著高于单支病变组,差异有统计学意义(P<0.05)。Chemerin与冠脉狭窄积分正相关(r=0.483,P<0.05)。多元Logistic逐步回归分析表明Chemerin为不稳定型心绞痛及病变狭窄程度的独立危险因素。结论高Chemerin引起冠状动脉病变不稳定和病变程度加重,Chemerin可作为判定冠心病患者冠状动脉病变稳定性和狭窄程度的指标之一。

Objective To explore the relationship between plasma chemerin level and stability of lesions, severity of coronary stenosis in patients with coronary heart disease. Methods 104 patients with coronary heart disease were selected for the study, among them, 60 patients with unstable angina pectoris,and 44 patients with stable angina pectoris. 40 patients with normal angiography were selected as control group. According to the number of vessels involved in angiography,104 patients were divided into triple-vessel,double-vessel and single-vessel lesions groups. Gensini score was used to evaluate the severity of coronary artery stenosis. Levels of chemerin were measured with ELISA. Results The levels of chemerin of the unstable angina pectoris group were significantly higher than those of the stable angina pectoris group and control group（P〈0.05）. The levels of chemerin in patients with triple-vessel were significantly higher than that with single-vessel lesions（P〈0.05）. The levels of chemerin of three vessel lesions groups were significantly higher than those in control group（P〈0.05）. Plasma chemerin level was positively associated with the score of coronary stenosis（r=0.433,P〈0.05）. Multiple regression analysis of Logistic indicated that chemerin was an independent risk for the stability of lesions and the severity of stenosis in patients with coronary heart disease. Conclusions Chemerin was independently related to the stability of lesions and the severity of stenosis in coronary artery. Chemerin might be the cause of instability of lesions and development of severity. Chemerin may be one of the predictors of stability and severity in coronary lesions.