血清视黄醇结合蛋白4对冠心病患者颈动脉粥样硬化的影响

目的观察血清视黄醇结合蛋白4（RBP4）水平对冠心病（CHD）患者颈动脉粥样硬化的影响，并探讨可能的作用机制。方法CHD患者60例，超声检查其颈动脉内膜中层厚度（IMT），根据超声检查结果将患者分为：增厚组40例，正常组20例：并同时检测此60例患者血清RBP4水平、丙二醛（MDA）含量血浆超氧化物歧化酶（SOD）活性及血脂。结果增厚组RBP4增高明显（P〈0．01）；MDA、年龄、TC、TG、LDL—C、SBP、DBP均有不同程度的上升，而SOD活性则表现为明显降低（P〈0．01或〈0．05）。血清RBP4水平与MDA、SBP、TG呈正相关（r值分别为0．225、0．231、0．245，均P〈0．05），与SOD则呈负相关（r=－0．241，P〈0．05）；以IMT是否增厚为凶变量行Logistic回归分析结果显示RBP4水平升高、高血压、年龄增高、血脂异常是CHD患者颈动脉内膜中层增厚的独立危险因素（OR值分别为1．172、1．025、1．151、1．046，P均〈0．01）。结论血清RBP4水平升高是CHD患者颈动脉粥样硬化的重要危险因素之一，其可能会增强血管内膜细胞的氧化应激反应。

The effects of serum retinol binding protein 4 to carotid artery atherosclerosis of patients with coronary heart disease

Objective To observe the effects of serum retinol binding protein 4 （RBP4） to carotid artery atheroselerosis of patients with coronary heart disease （CHD） and to discuss about the possible functional mechanism. Methods Sixty patients with CHD went ultrasonic inspection to measure carotid intima-media thickness （IMT） and were divided into thickening group with 40 patients and normal group with 20 patients according to ultrasonic inspection results. Serum level of RBP4 and Malonaldehyde （MDA）, blood fat and plasma superoxide dismutase （SOD） activity from patients in both groups were measured. Results Statistically significant differences （P 〈 0.01） existed in RBP4 level between the two groups with thickening group had a higher level. Statistically significant differences （P 〈 0.01 or P 〈 0.05） existed in items as MDA, age, TC, TG, LDL-C, SBP, DBP level which showed varying degrees of rise, and as SOD activity, which showed significantly lower level in thickening group. Serum RBP4 levels and MDA, SBP, TG was positively correlated （r values were 0.225, 0.231, 0.245, P 〈 0.05 for all）, while serum RBP4 levels and SOD was negative con＇elatcd （r = -0.241, P 〈 0.05）; as dependent variable were defined as the thickening of IMT, logistic regression analysis showed that RBP4 level, high blood pressure, increased age, dyslipidemia were independent risk factors for CHD patients with carotid artery endarterium thickness （OR values were 1.172, 1.025, 1.151, 1.046, P 〈 0.01 for all）. Conclusion Higher level of serum level of RBP4 is a fatal risk faetor to carotid artery atherosclerosis of patients with coronary heart disease with the possible risk to enhance oxidative stress in the intimal cells.