趋化因子CXCLl6与冠心病病变程度及胰岛素抵抗的关系

摘要：目的探讨冠心病患者趋化因子CXCChemokineLigand16（CXCLl6）水平与胰岛素抵抗（IR）及冠脉病变程度之间的关系。方法选择经冠状动脉造影证实的冠心病患者稳定型心绞痛（SAP）20例，急性冠脉综合征（ACS）24例。另有冠状动脉造影正常的20例作为对照组。平均年龄（62．61±10．37）岁。测定空腹血糖、空腹胰岛素、血脂、超敏C反应蛋白（hs—CRP）及血浆CXCLl6水平（采用酶联免疫吸附法）等生化指标。同时，根据稳态模式评估法计算胰岛素抵抗指数（iai），采用Gensini积分系统评估冠脉病变程度。观察各组之间CXCLl6水平与冠脉病变程度及1R1关系。结果冠心病患者血浆CXCLl6、hs—CRP水平、IRI和Gensini积分均高于对照组（P〈O．05）；冠心病患者中，ACS组hs—CRP、IRI和Gensini积分高于SAP组（P〈O．05）；SAP患者Gensini积分与CXCLl6，IRI与hs—CRP均呈正相关（r分别为0．476，0．591，P均〈0．05）。结论血浆CXCLl6水平和IRI均为冠心病的预测指标，它们对冠脉病变狭窄程度有一定的辅助预测作用。

Correlation of plasma CXCL16 level with coronary artery stenosis and insulin resistance in patients with coronary heart disease

Abstract：Objective To investigate the association between plasma CXCL16 level and coronary artery stenosis as well as insulin resistance （IR） in patients with coronary heart disease （CHD）. Methods A total of 64 inpatients received coronary angiography were allocated into： normal control group （n=20） ,stable angina pectoris （SAP） group （n=20） and acute coronary syndrome （ACS） group （n=24）. The concentration of plasma CXCL16 was measured using ELISA kit,insulin resistance index （IRI） was calculated by HOMA model. Gensini score was measured according to the severity of coronary artery lesions. Results The plasma levels of CXCL16 and high sensitive C reactive protein （hs-CRP）,IRI and Gensini score of CHD patients were significantly higher than those of the normal control group （P〈0.05）. Among CHD groups, the plasma levels of CXCL16 and hs-CRP and IRI in ACS group was significantly higher than those in SAP group （P〈0.05）. Gensini score was positively related with CXCL16 level,IRI was positively related with hs-CRP in SAP group （r=-0.476 and 0.591 respectively,P〈0.05）. Conclusions CXCL16,hs-CRP and IRI were all the predictors of CHD and hey can be used to predict the severity of coronary stenosis.