胱抑素C与冠状动脉易损斑块的相关性分析

摘要:目的　本研究探讨冠心病患者血清胱抑素C（Cys C）水平与冠状动脉易损斑块之间的相关性。方法　选择2008年6月-2009年6月我院住院经冠脉造影检查确诊冠心病的患者300例，以及冠脉造影正常者60例，按照术中斑块形态分为Ⅰ型斑块组85例，Ⅱ型斑块组139例，Ⅲ型斑块组76例，所有患者术前常规测定血清Cys C、高敏C反应蛋白（hs-CRP）及血脂水平。结果　Ⅱ型斑块组与对照组、Ⅰ型斑块组和Ⅲ型斑块组相比，Cys C、hs-CRP、低密度脂蛋白（LDL-C）水平升高（P＜0.05）；多元回归分析提示Cys C、hs-CRP、LDL-C是斑块稳定性的独立危险因素，其OR值分别为2.759、1.453和1.708；在Ⅱ型斑块组中Cys C及hs-CRP呈正相关（r＝0.635，P＜0.01），而肌酐和hs-CRP无明显相关性。结论　冠心病患者中血清中Cys C水平升高可能与冠状动脉易损斑块的发生具有正相关性。

Correlation between Cystatin C and vulnerable plaque of coronary artery disease

Abstract: Objective To study the relationship between Cystatin C (Cys C) and vulnerable plaque of coronary artery disease. Methods The coronary artery lesions were divided into typeⅠ, Ⅱ and Ⅲ plaque groups by the morphology of atherosclerotic plaque. Serum Cys C, hs-CRP and lipid were measured in 60 control subjects, 85 typeⅠplaque, 139 type Ⅱ plaque and 76 type Ⅲ plaque. Results Cys C, low density lipoprotein cholesterol (LDL-C) and hs-CRP were significantly higher in the patients with type Ⅱ than those in control, typeⅠand Ⅲ group (P<0.05), Based on multiple stepwise logistic regression analysis, Cys C, hs-CRP, LDL-C were independent risk factors of vulnerable plaque, respectively, the OR were 2.759、1.453、1.708 in type Ⅱ plaque group. The level of Cys C was correlated positively with hs-CRP in type Ⅱ group (r=0.635, P<0.01), but there were no same correlation between Cr and hs-CRP. Conclusion Elevated levels of serum Cys C may have a correlation with the occurrence of coronary vulnerable plaques, which may lead to changes in plaque stability through direct effects and inflammatory factors.