血清脂肪细胞因子水平与血管内皮功能及硬化程度的关系

Relationship between serum lipid cytokine levels and vascular endothelial function and degree of sclerosis

目的分析动脉粥样硬化(AS)患者血清脂肪因子与血管内皮功能和血管硬化程度的相关性,为动脉粥样硬化患者病情评估提供新思路。方法选择2015年2月至2016年2月大连大学附属中山医院收治的90例动脉粥样硬化患者作为研究对象,所有患者均检测血清脂肪细胞因子(血清脂联素、瘦素、抵抗素)、血管内皮功能指标[踝臂血压指数(ABI)、肱脉血流介导的血管舒张功能(FMD)、外周动脉张(PAT)]、血管硬化程度指标[颈总动脉中膜厚度(IMT)、脉搏波传导速度(PWV)]以及颈动脉造影。根据颈动脉造影结果将患者血管硬化狭窄程度分为轻度(33例)、中度(28例)和重度(29例)硬化狭窄。比较三组患者血清脂肪细胞因子水平的差异,同时分别分析血清脂肪细胞因子脂联素、瘦素、抵抗素与血管内皮功能指标、颈总动脉血管硬化程度指标之间的相关性。结果重度患者血清脂联素明显低于轻度和中度组,瘦素和抵抗素明显高于轻度和中度组,而中度组患者血清脂联素明显低于轻度组,瘦素和抵抗素明显高于轻度组,组间比较差异均有统计学意义(P<0.05);血清脂联素与ABI、FMD、PAT、IMT、PWV均呈负相关(r=-0.750、-0.693、-0.802、-0.765、-0.699,P<0.05),血清瘦素与ABI、FMD、PAT、IMT、PWV均呈正相关(r=0.694、0.704、0.721、0.759、0.687,P<0.05),血清抵抗素与ABI、FMD、PAT、IMT、PWV均呈正相关(r=0.705、0.684、0.649、0.731、0.695,P<0.05)。结论血清脂肪细胞因子水平可反映血管内皮功能障碍程度和血管硬化狭窄程度,为AS的病情诊断及治疗监控提供新思路。

Objective To analyze the correlation between serum adipocytokines and vascular endothelial function and degree of vascular sclerosis in patients with atherosclerosis（AS）, so as to provide new ideas for evaluating the condition of atherosclerosis patients. Methods A total of 90 cases of atherosclerosis patients, who admitted to Zhongshan Hospital Affiliated to Dalian University from February 2015 to February 2016, were selected as the objects. All patients were tested for serum adipocytokines（adiponectin, leptin, resistin）, vascular endothelial function indexes（ankle brachial blood pressure index [ABI], flow-mediated vasodilatation [FMD] of the brachial artery, peripheral artery[PAT]）, vascular sclerosis indexes（degree of carotid artery intima-media thickness [IMT], pulse wave velocity [PWV]）and carotid artery angiography. According to the degree of atherosclerotic stenosis, the patients were divided into mild（33 cases）, moderate（28 cases） and severe（29 cases） sclerostenosis groups. The differences of serum adipocytokines levels between the three groups were compared, and the correlation between serum adipocytokines adiponectin, leptin, resistin and endothelial function index and carotid atherosclerosis degree were analyzed. Results The serum adiponectin in the severe group was significantly lower than that in the mild and moderate group, while leptin and resistin in the severe group were significantly higher than those in mild and moderate group（P〈0.05）; serum adiponectin in the moderate group was significantly lower than that in the mild group, while leptin and resistin in the moderate group were significantly higher than those in mild group（P〈0.05）. Serum adiponectin was negatively correlated with ABI, FMD, PAT,IMT, PWV（r=-0.750,-0.693,-0.802,-0.765,-0.699, P〈0.05）; serum leptin and ABI, FMD, PAT, IMT and PWV were positively correlated（r=0.694, 0.704, 0.721, 0.759, 0.687, P〈0.05）; serum resistin and ABI, FMD, PAT, IMT, PWV had positive correlation（r=0.705, 0.684, 0.649, 0.731, 0.695, P〈0.05）. Conclusion The level of serum adipocytokines can reflect the degree of vascular endothelial dysfunction and the degree of vascular sclerosis stenosis, and to provide a new idea for the diagnosis and treatment monitoring of AS.