血清超敏C-反应蛋白、视黄醇结合蛋白4及血浆结合珠蛋白水平在冠心病患者中的变化及其意义

Changes of serum high-sensitivity C-reactive protein,retinol-binding protein 4 and plasma haptoglobin levels in patients with coronary heart disease and its significance

目的探讨冠心病(CHD)患者血清超敏C-反应蛋白(hs-CRP)、视黄醇结合蛋白4(RBP4)及血浆结合珠蛋白(Hp)水平的变化及其临床意义。方法选取2014年2月至2017年2月广安市人民医院心血管内科经冠状动脉造影检查确诊的CHD患者140例作为CHD组,另选取同期在我院心血管内科住院的非CHD患者60例作为对照组。将CHD组患者根据临床表现分为3个亚组:急性心肌梗死(AMI)组(n=38)、不稳定型心绞痛(UAP)组(n=62)和稳定型心绞痛(SAP)组(n=40)。依据病变支数分为3个亚组:单支病变组(n=27)、双支病变组(n=54)和三支病变组(n=59)。检测各组患者的血清hs-CRP、RBP4、Gensini评分及血浆Hp水平,并分析各指标与病情严重程度的关系。采用SPSS 16.0软件进行数据处理。依据数据类型,组间比较分别采用t检验和x^2检验。相关性分析采用Pearson线性相关分析法。结果 CHD组患者的血清hs-CRP[(7.29±3.65)vs(2.84±1.16)mg/L]、RBP4[(49.64±8.32)vs(42.07±5.51)ng/ml]及血浆Hp[(95.26±19.14)vs(70.13±16.33)mg/L]水平均显著高于对照组(P<0.05)。AMI亚组患者的血清hs-CRP、RBP4、Gensini评分及血浆Hp水平均显著高于SAP亚组和UAP亚组患者(P<0.05);UAP亚组患者的血清hs-CRP、RBP4、Gensini评分及血浆Hp水平均显著高于SAP亚组患者(P<0.05)。三支病变亚组患者的血清hs-CRP、RBP4、Gensini评分及血浆Hp水平均显著高于双支病变和单支比病变亚组患者(P<0.05);双支病变亚组患者的血清hs-CRP、RBP4、Gensini评分及血浆Hp水平均显著高于单支病变亚组患者(P<0.05)。CHD患者的Gensini评分与血清hs-CRP(r=0.619)、RBP4(r=0.554)及血浆Hp(r=0.592)水平均呈显著正相关(P<0.05)。结论 CHD患者血清hs-CRP、RBP4及血浆Hp水平显著升高,且与冠状动脉病变严重程度密切相关。

Objective To investigate the serum levels of high-sensitivity C-reactive protein（hs-CRP）and retinol-binding protein 4 （RBP4）and plasma level of haptoglobin（Hp）in the patients with coronary heart disease（CHD）and their clinical significance. Methods A total of 140 CHD patients diagnosed by coronary angiography in our department from February 2014 to February 2017 were recruited in this study,and assigned into CHD group.Another 60 patients hospitalized due to non-CHD in our department during the same period were assigned as control group.According to the clinical manifestations, the patients in the CHD group were further divided into 3 subgroups：acute myocardial infarction（AMI）group（n=38）, unstable angina pectoris（UAP）group（n=62）and stable angina pectoris（n=40）.And they were also assigned into single-vessel disease group（n=27）, double-vessel disease group （n=54）and triple-vessel disease group（n=59）according to the number of involved vessels.Gensini score,serum levels of hs-CRP and RBP4,and plasma level of Hp were evaluated and detected respectively.The relationship of these indices with the severity of CHD was analyzed.SPSS statistics 16.0 was used for data processing.Student＇s t test or Chi-square test were adopted for comparison of different data types between groups.Correlation between indices was analyzed by Pearson linear correlation analysis.Results The CHD group had significantly higher serum levels of hs-CRP[（7.29 ±3.65）vs（2.84 ±1.16））mg/L], RBP4[（49.64 ±8.32）vs （42.07 ±5.51）ng/ml]and plasma level of Hp[（95.26 ±19.14）vs（70.13 ±16.33）mg/L]than the control group（P〈0.05）.The serum levels of hs-CRP and RBP4,Gensini score and plasma Hp level were significantly higher in the AMI patients than the SAP and UAP patients（P〈0.05）.So were in the UAP patients than the SAP patients（P〈0.05）.The triple-vessel disease subgroup also had higher above indices than the double-vessel disease subgroup（P〈0.05）, and such trends were also seen between the double-vessel and single-vessel disease subgroups（P〈0.05）.Gensini score of the CHD patients were positively correlated with serum levels of hs-CRP（r=0.619）,RBP4（r=0.554）,and plasma Hp level（r=0.592,all P〈0.05）.Conclusion The CHD patients have obviously higher serum levels of hs-CRP, RBP4 and plasma level of Hp, which are significantly related to the severity of coronary lesions.