血清脂联素与中年男性冠状动脉病变程度的相关性研究

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血清脂联素与中年男性冠状动脉病变程度的相关性研究

袁　帅1　蔡尚郎2

【摘要】　目的　观察中年男性血清脂联素水平与冠心病发生及冠脉病变程度的相关性。方法　选取经冠脉造影证实的32例冠脉粥样硬化者(冠脉狭窄<50%)、86例冠心病患者(冠脉狭窄>50%),并选30例冠脉正常者作为对照组,用EL ISA法进行血清脂联素的测定,同时检测体重指数(BM I)、空腹血糖(FP G)、血浆胰岛素水平(FINS)、甘油三酯(T G)和总胆固醇(TC)等相关指标,计算HOMA2IR指数。结果　冠心病组及冠脉粥样硬化组血清脂联素浓度明显低于对照组(P<0101),冠心病组脂联素浓度明显低于冠状动脉粥样硬化组(P<0105)。冠心病组中急性冠脉综合征脂联素浓度明显低于稳定性心绞痛组(P<0101)。冠状动脉三支病变组、双支病变组及单支病变组血清脂联素浓度明显低于对照组(P<0101)。三支病变组血清脂联素水平低于单支病变组及双支病变组(P<0105),而双支病变组与单支病变组血清脂联素水平差别无统计学意义(P>0105)。冠心病血清脂联素水平与体重指数、低密度脂蛋白(LDL2C)呈负相关(r分别为-01291、-01221,P<0105),与HORA2IR指数呈显著负相关(r=-01476,P<0101)。多元线性回归分析结果显示,HORA2IR指数是影响冠心病患者血清脂联素的最重要因素(r2=0146,P<0101)。结论　脂联素参与中年男性冠状动脉粥样硬化病变的发生发展,冠心病患者血清脂联素的水平降低,且其浓度变化与动脉粥样硬化斑块的稳定性和病变程度有关。

【关键词】　冠心病;动脉粥样硬化;脂联素;危险因素

【中图分类号】　R541.4 【文献标识码】　A

R elative Study of Serum Adiponectin and the Degree of Coronary Artery Stenosis in Middle2aged Male Patients Yuan S huai,et al.Medical College,Qing dao Universit y.Qing dao,266021【Abstract】　Objective　To explore t he relationship between t he variation of serum adiponectin and t he degree of coronary artery stenosis in middle2aged male patient s.　Methods　The serum adiponectin levels were measured by EL ISA in32middle2aged male patient s wit h coronary at hero sclerosis(coronary steno sis less t han50%),86middle2aged male patient s wit h coronary heart disease(coronary stenosis more t han 50%)and30cont rol subject s wit h normal coronary artery.Meanwhile fasting plasma gluco se(FP G),fast2 ing insulin(FINS),total cholesterol(TC)and triglyceride(T G)were measured and HOMA2IR index was calculated.The degree of artery stenosis was confirmed by coronary angiograp hies.R esults　The serum adiponectin concent ration in middle2aged male patient s wit h coronary at herosclero sis(ASO)and coronary heart disease(C HD)was significantly lower t han t hat of cont rol group respectively(P<0101).Serum con2 cent ration of adiponectin in C HD patient s was significantly lower t han t hat in ASO(P<0105).Serum con2 cent ration of adiponectin in ACS patient s was significantly lower t han t hat in SA P(P<0101).The serum adiponectin concent ration in middle2aged male patient s wit h t riple,double and single vessel disease was sig2 nificantly lower t han t hat of cont rol group respectively(P<0101).Adiponectin of triple vessel disease was significantly lower t han t hat of double and single vessel disease respectively(P<0105).Serum adiponectin levels correlated negatively wit h BM I,LDL2C(r=-01291,-01221,P<0105)and HORA2IR index(r= -01476,P<0101).Multiple linear regression showed t hat HORA2IR index was independently correlated wit h t he concent ration of adipo nectin in middle2aged male patient s wit h C HD(r2=0146,P<0101).Con2 clusion　Adiponectin might be involved in t he pat hop hysiologic process of coronary at herosclerosis in mid2 dle2aged male patient s.The concent ration of serum adiponectin decreases in CHD and it s variation reflect s t he stability and degree of at hero sclerotic lesion.

【K ey w ords】　Adiponectin;Coronary heart disease;At herosclerosis;Risk factor

作者单位　1.青岛大学医学院　266021

2.青岛大学医学院附属医院心内科

脂联素是由脂肪细胞分泌的一种胶原样血浆激素蛋白,1995年首先发现于小鼠脂肪细胞,将其称为脂肪细胞补体相关蛋白30(Acrp30);1996年在