血浆Apelin在不同类型冠心病中的表达及与左心室重构的关系

Expression of apelin in different types of coronary heart disease and the relationship between apelin and left ventricular remodeling

目的 比较不同类型冠心病患者血浆中的apelin浓度，并探讨其与冠心病严重程度、左心室重构的关系。方法 入选2014年7月~2014年12月昆山市第一人民医院首次以冠心病诊断入院的患者99例，分为稳定型心绞痛组（SAP）、不稳定型心绞痛组（UAP）、急性心肌梗死组（AMI），选择年龄相当并且冠状动脉造影排除冠心病的29例患者为对照组；应用酶联免疫吸附法（ELISA）测定血浆apelin浓度，记录超声心动图指标左心室收缩末期内径（LVDs）和左心室舒张末期内径（LVDd）。比较四组患者血浆apelin水平，观察AMI、UAP、SAP三组冠心病患者血浆apelin水平及与左心室功能指标——LVDs、LVDd的关系。结果 AMI组、UAP组的血浆apelin水平显著低于对照组（P＜0.05），而SAP组与对照组相比血浆apelin水平无统计学差异（P＞0.05）；AMI组、UAP组、SAP组三组间两两比较，apelin浓度均有统计学差异（P＜0.05）。血浆apelin浓度与左心室收缩末期内径（LVDs）、左心室舒张末期内径（LVDd）均呈显著负相关，r值分别为-0.403和-0.305（P＜0.05）。结论 不同类型冠心病患者表达apelin水平不同，apelin水平可能与冠心病患者的左心室重构存在相关性。

Objective To investigate expression of apelin in patients with different types of coronary heartdisease (CHD), and the relationship between apelin and left ventricular remodeling. Methods Ninety-nine patientsinitially admitted for CHD were divided into three groups: stable angina pectoris(SAP) group, unstable anginapectoris(UAP) group and acute myocardial infarction (AMI) group. Twenty-nine age matched patients with CHDexcluded after coronary angiography(CAG) were involved as the control group. Plasma apelin levels were determinedby enzyme-linked immunoabsorbent assay (ELISA). The left ventricular end systolic dimension (LVDs) and leftventricular end diastolic dimension (LVDd) were measured and recorded by the ultrasonic cardiography (UCG).Plasma apelin levels among four groups were compared. And relationship between plasma apelin levels of AMI,UAP, SAP groups with LVDs and LVDd were analyzed. Results Compared to the control group, plasma apelinin AMI group and UAP group was significantly lower (P<0.05). And there was no significant difference of plasmaapelin between control group and SAP group (P>0.05). Among the AMI, UAP and SAP groups, plasma apelin levelwas significantly different (P<0.05). Plasma apelin was negatively correlated with LVDs and LVDd (r=-0.403 and -0.305 respectively, P<0.05). Conclusion Plasma apelin levels were different in different types of CAG, andplasma apelin level may be associated with the left ventricular remodeling.