YKL-40和超敏C反应蛋白与冠心病的相关性

目的研究超敏C反应蛋白(hsCRP)和YKL-40与冠状动脉病变程度的关系。方法采用Judkins法进行冠状动脉造影,确诊冠心病259例及冠状动脉造影结果正常的对照组251例。应用酶联免疫法测定hsCRP和YKL-40浓度。冠状动脉病变分为1支病变(123例),2支病变(68例)和3支病变组(68例)。采用病例对照的方法进行研究。结果 YKL-40对冠心病易感性预测的受试者特征工作曲线(ROC)下面积(AUC)为0.671[95%可信区间(CI)为1.00-1.02;P<0.01];hsCRP对冠心病易感性预测的AUC为0.778(95%CI为1.24-1.50;P<0.01)。冠心病3支血管病变组血浆hsCRP和YKL-40水平明显高于1支、2支血管病变组(P<0.05或P<0.01);3支血管病变组血浆YKL-40水平明显高于2支血管病变组(P<0.05),而hsCRP在该两组间未见明显差异。在对体重指数(BMI)、高血压史、糖尿病史、吸烟史、高脂血症、TC、LDL-C、hsCRP和YKL-40调整后发现,hsCRP、YKL-40是冠心病最显著的独立相关危险因素(OR=1.37,95%CI为1.24-1.50,P<0.01;OR=1.01,95%CI为1.00-1.02,P<0.01)。结论 hsCRP、YKL-40与冠心病之间有显著相关性。

Correlation of YKL-40 and hsCRP with coronary artery disease

Objective To investigate whether the plasma high sensitive C-reactive protein(hsCRP) and YKL-40 levels were correlated with the susceptibility and severity of coronary atherosclerosis.Methods Plasma YKL-40 and hsCRP were measured by enzyme-linked immunosorbent assay in 259 cases with coronary artertery disease(CAD) and 251 cases without CAD,who were diagnosed by coronary angiography.CAD patients were assgined to three groups of A(123 cases with 1-vessel stenosis),B(68 cases with 2-vessel stenosis) and C(68 cases with 3-vessel stenosis).Results In predicting the susceptibility for CAD,the AUC of YKL-40 was 0.671(95% CI=1.00-1.02,P<0.01),which of hsCRP was 0.778(95%CI=1.24-1.50,P<0.01).Plasma levels of YKL-40 and hsCRP were higher in group C than those in groups of A and B(P<0.05 and P<0.01).Plasma YKL-40,but not hsCRP,was higher in group C than that in group B(P<0.05).After full adjustment of hypertension,diabetes,smoking,hypercholesterolemia,TC and LDL-C,YKL-40 and hsCRP were two independent risk factors for CAD(OR=1.37,95% CI=1.24-1.50,P<0.01 and OR=1.01,95% CI=1.00-1.02,P<0.01).Conclusion It is concluded that there is a close relationship between plasma levels of YKL-40 and hsCRP and the severity of CAD.