冠心病病人血清脂联素水平的测定及意义

目的 观察冠心病（CHD）病人血清脂联素的变化并探讨其临床意义。方法 选择60例冠心病病人，其中急性心肌梗死（AMI）15例，陈旧性心肌梗死（OMI）15例，不稳定型心绞痛（UAP）15例，稳定型心绞痛（SAP）15例；并选20例健康人做对照组，进行血清脂联素的测定，同时检测空腹血糖（FPG）、三酰甘油（TG）和总胆固醇（TC）等相关指标。结果 冠心病病人血清脂联素的浓度显著低于对照组，且男女存在性别差异（P〈0．05）。AMI组血清脂联素的浓度显著低于OMI组、SAP组和对照组（P〈0．05、0．01），UAP组脂联素的浓度显著低于SAP组和对照组（P〈0．05）。但OMI组、SAP组与对照组比较差异无显著性（P〉0．05）。血清脂联素的浓度与FPG、TG呈负相关（r=-0．309、-0．333，P〈0．05）。多元线性逐步回归分析显示，TG是影响冠心病病人血清脂联素的最重要因素。结论 脂联素参与了冠心病的发病，冠心病病人血清脂联素的水平降低，且其浓度变化与动脉粥样硬化斑块的稳定性有关。

DETERMINATION OF CONCENTRATION OF ADIPONECTIN IN PATIENTS WITH CORONARY HEART DISEASE

Objective To investigate the variation of serum adiponectin in patients with coronary heart disease (CHD) and to explore its significance. Methods Serum concentration of adiponectin was measured in 60 patients with CHD and 20 control participants. The patients were allocated into four equal groups:acute myocardial infarction (AMI);old myocardial infarction (OMI); unstable angina pectoris (UAP);and stable angina pectoris (SAP). Fasting plasma glucose (FPG),total cholesterol (TC) and triglyceride (TG) were measured at the same time. Results Serum concentration of adiponectin in CHD patients was significantly lower than that in the control group, and there were sex differences (P<0.05). Serum concentration of adiponectin in AMI patients was significantly lower than that in OMI and SAP and in the control group (P<0.05,0.01),and adiponectin in UAP was significantly lower than SAP and control group (P<0.05). Serum adiponectin correlated negatively with FPG and TG (r=-0.309,-0.333;P<0.05). Multiple linear regression showed that TG was independently correlated with the concentration of adiponectin level in patients with CHD. Conclusion Adiponectin plays a role in the pathogenesis of coronary atherosclerosis. The concentration of serum adiponectin decreases in CHD and its variation reflects the stability of atherosclerotic lesion.