可溶性晚期糖基化终末产物受体与心脑动脉粥样硬化的相关性

Association between soluble receptor for advanced glycation end products(sRAGE)and coronary and cerebral atherosclerosis

目的探讨可溶性晚期糖基化终末产物受体(sRAGE)与心脑动脉粥样硬化的相关性。方法纳入2018年5—12月于首都医科大学附属北京天坛医院心血管内科住院同时接受冠状动脉造影术和颅脑CT血管成像(或全脑造影)的患者232例,其中对照组55例(非冠心病非脑血管狭窄患者)、冠心病组118例(冠心病非脑血管狭窄患者)、脑血管狭窄组11例(脑血管狭窄非冠心病患者)及冠心病合并脑血管狭窄组48例。采用酶联免疫反应法检测并比较各组间血浆sRAGE水平。分析sRAGE与Gensini(GS)评分及脑血管狭窄程度、脑血管狭窄支数的相关性,比较低、中、高GS评分组sRAGE水平。结果冠心病组sRAGE水平高于对照组(1.96μg/L比1.66μg/L,P=0.025)及脑血管狭窄组(1.96μg/L比1.53μg/L,P=0.013),而与冠心病合并脑血管狭窄组(1.89μg/L)比较差异无统计学意义(P>0.05)。在本研究整体人群中sRAGE水平与GS评分正相关(r=0.153,P=0.023);在糖尿病患者群中sRAGE水平与GS评分相关性更高(r=0.242,P=0.017)。中、高GS组患者的sRAGE水平均高于低GS评分组(P<0.05)。sRAGE水平与脑血管狭窄程度及支数无明显相关(P>0.05)。颅外脑血管狭窄组与颅内脑血管狭窄组比较差异无统计学意义(1.84μg/L比1.66μg/L,P=0.523)。结论sRAGE水平与冠状动脉粥样硬化严重程度正相关,而与脑血管动脉硬化的相关性仍需进一步研究。

Objective To investigate the Association between soluble receptor for advanced glycation end products(sRAGE)and coronary and cerebral atherosclerosis.Methods A total of 232 consecutive patients who synchronously undertook coronary angiography and craniocerebral CT angiography(or total cerebral angiography)were included between May 2018 and December 2018 in Beijing Tiantan Hospital,Capital Medical University in this study.Patients were divided into the control group(without coronary artery disease(CAD)and cerebrovascular stenosis(CVS),n=55),CAD group(n=118),CVS group(n=11),concomitant CAD and CVS group(CAD+CVS,n=48).Plasma sRAGE level was measured by enzyme-linked immunosorbent assay(ELISA)and compared among the four groups.The relationship between sRAGE and Gensini Score(GS)and cerebrovascular stenosis severity was assayed.sRAGE levels were compared among low,middle and high GS group as well as between extracranial and intracranial arteries stenosis.Results The levels of sRAGE in CAD group(1.96μg/L)were higher than those in the control group(1.66μg/L,P=0.025)or the CVS group(1.53μg/L,P=0.013).However,no significant difference in sRAGE level was found between the groups of CAD and CAD+CVS(1.89μg/L,P>0.05).Meanwhile,sRAGE was positively associated with GS in the entire study population(r=0.153,P=0.023)or in the diabetic patients(r=0.242,P=0.017).The sRAGE leves in both middle GS and high GS groups were higher than those in low GS group(P<0.05).No association between sRAGE and CVS severity and vascular count.Additionally,no significant difference in levels of sRAGE was found between extracranial(1.84μg/L)and intracranial arteries stenosis(1.66μg/L,P=0.523).Conclusion Plasma sRAGE level is positively associated withseverity of CAD,but its association with cerebral atherosclerosis needs further studies.