外周血内脂素水平与冠心病的相关性

目的 结合血清高敏C反应蛋白,探讨血清内脂素在预测冠心病斑块稳定性及冠状动脉病变程度的价值.方法 对入选对象行冠状动脉造影,同步进行心电图、外周血内脂素、高敏C反应蛋白、肌酸激酶同工酶、心肌肌钙蛋白Ⅰ参数检测和常规身体检查后设正常对照组(25例)和冠心病组(78例);再将冠心病组分为稳定型心绞痛组(34例)、不稳定型心绞痛组(20例)和急性心肌梗死组(24例);同时也将78例冠心病病例分为冠状动脉单支病变(24例)与多支病变(54例).比较组间外周血内脂素、高敏C反应蛋白水平差异,评价两者在冠心病患者中的相关性及其与冠状动脉病变程度的相关性.结果 冠心病组血清内脂素、高敏C反应蛋白水平显著高于正常对照组(P<0.05);血清内脂素、高敏C反应蛋白水平急性心肌梗死组显著高于不稳定型心绞痛组(P<0.05),不稳定型心绞痛组显著高于稳定型心绞痛组(P<0.05);血清内脂素与高敏C反应蛋白水平无明显相关性(P>0.05);多支病变组与单支病变组内脂素水平差异无显著性(P>0.05),而多支病变组高敏C反应蛋白显著高于单支病变组(P<0.05).结论 内脂素和高敏C反应蛋白在预测冠心病中有重要价值,它们在冠心病外周血中浓度的升高可以提示冠状动脉粥样斑块的不稳定,但两者无相关性;高敏C反应蛋白在预测冠状动脉病变程度方面有一定作用,但还不能以内脂素作为预测冠状动脉病变程度的指标.

Clinical Value of Serum Visfatin in Patients with Coronary Artery Disease

Aim To determine the clinical value of serum visfatin, as well as to investigate the relationship be-tween the serum level of visfatin and the severity of coronary artery disease (CAD) combined with high sensitive C-reative protein( hs-CRP).Methods All the subjects underwent coronary angiography and serum visfatin, creatine kinase M B isoenzyme (CK-MB), cardiac troponin-Ⅰ(cTnⅠ) and hs-CRP were measured in the subjects.According to diag-nostic results, all cases were divided into two groups, normal control group(25 cases) and CAD group (78 cases).At the same time, the 78 cases of CAD were divided into three groups, 34 cases of stable angina pectoris (SAP), 20 cases of unstable angina pectoris (UAP), 24 cases of acutemyocardial infarction (AMI).Then CAD group were divided into 24 cases of single vessel coronary disease (1 branch) and 54 cases of multivessel coronary disease(≥2 branches or left trunk).The levels and relationship of serum visfatin and hs-CRP among these groups were compared and analyzed.The relationship between the severity of CAD and the two indicators was evaluated.Results The levels of serum visfa-tin and hs-CRP in the group of CAD were higher than those of normal control group.The levels of serum visfatin and hs-CRP in the UAP group were higher than that in SAP group(P<0.05), which in the AMI group were higher than that in UAP group(P<0.05).There was no significant correlation between serum visfatin and hs-CRP levels (P>0.05).In the 78 cases of CAD, there was no significant difference of serum visfatin levels between multivessel coronary disease group and single-vessel coronary disease group (P>0.05), but the levels of serum hs-CRP in multivessel coronary dis-ease group were higher than those in single-vessel coronary disease group.Conclusion The increased serum levels of visfatin and hs-CRP in patients with CAD may predict the unstable conditions of plaques.Hs-CRP plays a role in predic-ting the severity ofCAD to some extent.Butwe should not predict the severity of CAD by the level of serum visfatin.