肠道屏障功能及脂代谢对冠心病的影响

Effects of intestinal barrier function and lipid metabolism on coronary heart disease

目的探讨肠道屏障功能及脂代谢对冠心病的影响。方法纳入陕西中医药大学附属医院2019年8月至2021年8月收治的冠心病患者139例,根据Gensini积分对冠心病患者进行冠状动脉病变程度分级,分成轻度组(41例,Gensini积分<25分)、中度组(61例,Gensini积分25~50分)、重度组(37例,Gensini积分>50分)。另选取同期健康体检者62例为对照组。比较4组血清D-乳酸、二胺氧化酶(DAO)、内毒素(ET)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平,分析上述各项指标水平与Gensini积分的相关性。结果轻、中、重度组血清D-乳酸、DAO、ET水平较对照组升高,中、重度组血清D-乳酸、DAO、ET水平较轻度组升高,重度组血清D-乳酸、DAO、ET水平较中度组升高,差异有统计学意义(P<0.05)。轻、中、重度组TC、TG、LDL-C水平较对照组升高,HDL-C水平较对照组下降,且重度组TC、TG、LDL-C水平较轻、中度组升高,HDL-C水平较轻、中度组下降,差异有统计学意义(P<0.05)。冠心病患者Gensini积分与血清D-乳酸、DAO、ET、TC、TG、LDL-C水平均呈正相关(P<0.05),与HDL-C水平呈负相关(P<0.05)。结论冠心病患者存在肠道屏障功能障碍与脂代谢紊乱,且二者的异常改变会影响冠状动脉病变程度。

Objective To investigate the effects of intestinal barrier function and lipid metabolism on coronary heart disease.Methods A total of 139 patients with coronary heart disease admitted to the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from August 2019 to August 2021 were included.Coronary artery lesions were graded according to the Gensini score,and the patients were divided into mild group(41 cases,Gensini score<25 points),moderate group(61 cases,Gensini score 25—50 points),severe group(37 cases,Gensini score>50 points).A total of 62 healthy subjects during the same period were selected as the control group.Compared the serum D-lactate,diamine oxidase(DAO),endotoxin(ET),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)levels among the 4 groups,and the correlation between the above indexes levels and Gensini score was analyzed.Results Serum levels of D-lactic acid,DAO and ET in the mild,moderate and severe group were higher than those in the control group,serum D-lactic acid,DAO and ET levels in the moderate and severe group were higher than those in the mild group,serum D-lactic acid,DAO and ET levels in the severe group were higher than those in the moderate group,and the differences were statistically significant(P<0.05).Compared with the control group,the levels of TC,TG and LDL-C in the mild,moderate and severe groups were increased,and the level of HDL-C was decreased,the levels of TC,TG and LDL-C in the severe group were higher than those in the mild and moderate groups,while the level of HDL-C was lower than that in the mild and moderate groups,and the differences were statistically significant(P<0.05).The Gensini score of patients with coronary heart disease was positively correlated with the levels of serum D-lactate,DAO,ET,TC,TG and LDL-C(P<0.05),and negatively correlated with the level of HDL-C(P<0.05).Conclusion Patients with coronary heart disease have intestinal barrier dysfunction and abnormal lipid metabolism,and the abnormal changes of the two will affect the degree of coronary artery lesions.