血清硫酸吲哚酚水平与冠心病严重程度的关系研究

Relationship between levels of indoxyl sulfate and severity of coronary artery disease

目的硫酸吲哚酚(IS)与内皮损伤、NF-κB的激活以及动脉粥样硬化的发生发展有关。本研究拟探索血清IS水平与冠心病(CAD)严重程度指标以及多种心血管风险因素之间的关系。方法入选疑诊CAD的患者503例,对其进行冠状动脉造影以及冠状动脉CTA检查,计算病变血管支数、Gensini积分以及钙化积分等,使用超高效液相色谱法对所有入选患者血清IS水平进行检测,分析血清IS水平与病变血管支数、Gensini积分以及钙化积分等之间的关系。结果与冠脉正常的患者比较,CAD患者的血清IS水平较高,并且冠状动脉狭窄程度严重的患者,其血清IS浓度也较高;其次,使用多变量分析发现,血清IS水平与CAD的发病率和严重程度独立相关。此外,血清IS水平和年龄、冠状动脉钙化积分、Gensini积分、冠状动脉斑块以及Framingham-10年风险积分也相关。结论本研究发现,血清IS水平在CAD患者中明显升高,与其严重程度有关。这就说明,升高的血清IS水平可能参与了冠状动脉粥样硬化的病理过程。

Objective Indoxyl sulfate （IS） is associated with endothelial damage, NF-κB activation and induces the development of atherosclerosis. The purpose of this study was to investigate the relationship between serum IS levels and the severity of coronary artery stenosis and the relationship among IS and various cardiovascular risk factors. Methods Serum IS concentrations were measured using uhra performance liquid chromatography in 191 consecutive patients presenting with stable angina. The associations between serum IS levels and angiographic indexes of the number of diseased vessels, modified Gensini scores and calcium scores were determined. Results Patients with significant coronary artery stenosis were found to have higher serum IS levels than those with normal coronary arteries. Multivariate analysis showed that serum IS levels were found to be independently associated with the presence and severity of coronary artery disease （CAD）. Furthermore, statistically significant correlation was observed between the serum IS levels and age, Agatston calcium score, volume calcium score, modifed Gensini score, coronary lesions, coronary disease and Framingham-10 year risk score. Conclusions Serum IS levels are significantly higher in the presence of CAD and correlate with the severity of the disease and coronary atherosclerosis scores, which suggests that increased serum IS may be involved in the pathogenesis of coronary atherosclerosis.