老年冠心病合并类风湿关节炎患者胃饥饿素/肥胖抑制素比值变化及临床意义

Changes and clinical significance of Ghrelin/obestatin ratio in elderly patients with coronary heart disease complicated with rheumatoid arthritis

目的探讨老年冠心病合并类风湿关节炎(RA)患者胃饥饿素(Ghrelin)/肥胖抑制素(obestatin)比值变化及临床意义。方法收集冠心病患者117例作为研究对象,根据是否合并RA分为冠心病RA组(n=49)和单纯冠心病组(n=68),选择同期健康体检者50例作为对照组。采用酶联免疫法(ELASA)测定血清Ghrelin、obestatin水平。根据冠脉造影结果采用Gensini积分评估冠脉病变程度。结果冠心病RA组、单纯冠心病组患者的Ghrelin/obestatin比值显著低于对照组,冠心病RA组患者的Ghrelin/obestatin比值明显低于单纯冠心病组,差异均有统计学意义(P<0.05);冠心病RA组患者的Gensini积分明显高于单纯冠心病组,差异有统计学意义(P<0.05)。冠心病RA组患者的Ghrelin/obestatin比值与Gensini积分呈负相关(r=-0.56,P<0.05)。结论老年冠心病合并RA患者的Ghrelin/obestatin比值与冠状动脉病变程度密切相关。Ghrelin/obestatin比值在预测冠心病合并RA中有一定的辅助参考价值。

Objective To investigate the changes and clinical significance of Ghrelin / obestatin ratio in elderly patients with coronary heart disease complicated with rheumatoid arthritis（ RA）. Methods 117 cases of coronary heart disease patients were collected as research subjects,who were divided into coronary heart disease complicated with RA group（ n = 49） and simple coronary heart disease group（ n = 68） according to whether the complication occurred; 50 cases of healthy volunteers were selected as the control group at the same period. Enzyme- linked immunosorbent assay（ ELISA） method was used to determine serum Ghrelin and obestatin levels. Gensini score was used to evaluate the extent of coronary lesions according to the results of coronary angiography. Results The Ghrelin / obestatin ratios of coronary heart disease complicated with RA group and simple coronary heart disease group were significantly lower than the control group; and that of coronary heart disease complicated with RA group was significantly than the simple coronary heart disease group,with the differences statistically significant（ P〈0. 05）. The Gensini scores of coronary heart disease complicated with RA group were significantly higher than the simple coronary heart disease group,and the differences were statistically significant（ P〈0. 05）. The Ghrelin / obestatin ratio of patients with coronary heart disease complicated with RA was negatively correlated with Gensini score（ r =- 0. 56,P〈0. 05）. Conclusion Ghrelin / obestatin ratio is closely related to the severity of coronary artery disease in elderly patients with coronary heart disease complicated with RA. Ghrelin / obestatin ratio has a supplementary reference value in predicting coronary heart disease combined with RA.