应用血管内超声对内源分泌型晚期糖基化终产物受体水平与糖尿病冠状动脉硬化斑块关系的研究

Preliminary study on the relationship between the level of esRAGE and diabetic coronary atherosclerotic plaques by intravascular ultrasound

目的分析内源分泌型晚期糖基化终产物受体(esRAGE)水平与冠心病(CHD)合并糖尿病患者冠状动脉粥样硬化斑块严重程度的相关性。方法选取2015年4月至2017年7月于福建医科大学附属第二医院心内科住院的经冠状动脉造影(CAG)确诊的CHD患者53例,分为CHD合并T2DM组(CHD+T2DM,n=11)与单纯CHD组(CHD,n=42)。应用血管内超声进行冠状动脉斑块分析,检测冠脉最小血管直径、最小管腔面积和斑块负荷(PB)。ELISA法测定血浆esRAGE水平。结果CHD+T2DM组与CHD组比较,血浆esRAGE[(0.2860±0.1097)vs(0.4738±0.2455)μg/L,P=0.017]、最小血管直径[(1.85±0.16)vs(2.19±0.59)mm,P=0.002)、最小管腔面积[(3.64±1.51)vs(5.32±2.95)mm2,P=0.014]及PB[(73.69±5.91)%vs(67.23±14.57)%,P=0.03]差异均有统计学意义。多元线性回归分析显示,SBP与PB呈正相关,esRAGE与PB呈负相关(P<0.05),提示高SBP和低esRAGE是PB的危险因素。结论糖尿病加剧CHD患者冠状动脉粥样硬化斑块的严重程度;低血浆esRAGE水平可能是冠状动脉粥样硬化斑块病变的危险因素。

Objective To analyze the relationship between plasma endogenous secretion receptor for the advanced glycation end-products（esRAGE）and the severity of coronary atherosclerotic plaques in patients of coronary atherosclerotic heart disease（CHD）with diabetes mellitus（DM）. Methods 53 CHD patients diagnosed by coronary angiography were enrolled and divided into two groups according to with or without DM.Intravascular ultrasound（IVUS）was applied to determine the degree of lesion of coronary artery with the minimum lumen diameter（MLD）,minimum lumen area（MLA）and plaque burden（PB）.The plasma esRAGE level was measured with enzyme-linked immunosorbent assay（ELISA）. Results There were significant differences between CHD group and CHD＋DM group in the levels of esRAGE [（0.2860±0.1097）vs（0.4738±0.2455）μg/L,P=0.017],MLD [（1.85±0.16）vs（2.19±0.59）mm,P=0.002],MLA [（3.64±1.51）vs（5.32±2.95）mm2,P=0.014]and PB [（73.69±5.91）% vs（67.23±14.57）%,P=0.03].Linear multivariate regression analysis showed that higher systolic blood pressure and lower esRAGE level were risk factors of PB. Conclusion DM exacerbates the progress of arteriosclerosis in CHD. The lower plasma esRAGE level may associate with arteriosclerosis.