血清脂联素水平与冠脉病变程度及炎症标志物变化的关系

目的探讨血清脂联素水平与冠脉病变严重程度及炎症标志物变化的关系。方法对176例可疑冠状动脉粥样硬化性心脏病（简称冠心病）患者行冠状动脉造影检查并检测其血清脂联素及超敏C-反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF—α）、白介素-6（IL-6）、可溶性E-选择素（sE—s）、可溶性细胞间黏附分子-1（sICAM-1）水平，根据冠状动脉造影结果及冠脉病变的Gensini评分将患者进行分组，比较各组血清脂联素及炎症标志物水平的差异；用多元逐步回归筛选脂联素的影响因素。结果①冠心病患者血清脂联素水平明显低于正常对照组（P〈0．01），血清炎症标志物水平明显高于正常对照组（P〈0．05，P〈0．01）；②随着冠脉病变Gensini评分的增加血清脂联素水平逐渐降低（P〈0．05，P〈0．01），血清炎症标志物水平逐渐增高（P〈0．05，或P〈0．01）；③脂联素与高密度脂蛋白胆固醇呈正相关，与BMI、甘油三酯、hs-CRP、TNF—α、sICAM-1水平及冠脉病变Gensini评分呈负相关（P〈0．01）。结论冠心病患者血清脂联素水平降低，血清炎症标志物水平增高，低脂联素血症是冠脉病变严重程度的标志，脂联素具有抗炎、抗动脉粥样硬化作用。

Correlation between Serum Level of Adiponectin Severity of Coronary Artery Atherosclerosis and Serum Inflammatory Marker Levels

Objective To investigate the correlation between serum level of adiponectin and severity of coronary artery atherosclerosis,serum inflammatory marker levels. Methods Coronary angiographies were performed in 176 cases with suspected coronary heart disease (CHD) and the concentrations of serum adiponectin, hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-α(TNF-α), interleukin-6 ( IL-6), soluble Eselectin (sE-s) and soluble intercellular adhesion molecule-1 (sICAM-1) were measured. Patients were divided into groups according to the results of coronary angiographies and Gensini's scores of coronary artery atherosclerosis. The serum levels of adiponectin and inflammatory marker were compared in different groups, and multiple regressions were used to analyze the correlation factors of adiponectin. Results ①Serum adiponectin concentration in CHD group was decreased as compared with that in control group (P <0. 01 ). Serum inflammatory marker levels was increased (P < 0. 05, P < 0. O1).②The serum levels of adiponectin fell and the serum levels of inflammatory marker increased while the Gensini's scores of coronary artery atherosclerosis increased (P < 0.05, P < 0. 01) ;③Serum level of adiponectin was positively correlated with the high-density lipoprotein cholesterol, while negatively correlated with body mass index, the serum levels of triglyceride, hs-CRP, TNF-α, sICAM-1 and the Gensini's score of coronary artery atherosclerosis (P < 0. 01). Conclusion Serum adiponeetin concentration was decreased and the serum level of inflammatory markers were increased in patients with CHD. Low serum level of adiponectin reflected the severity of coronary artery atherosclerosis. Adiponectin has anti-inflammation and anti-artery atherosclerosis effects.