可溶性糖蛋白130与稳定型冠心病患者冠状动脉粥样硬化严重程度之间关系

目的: 评估稳定型冠状动脉疾病（stable coronary artery disease, CAD）患者血清白细胞介素-6（IL-6）、可溶性IL-6受体（sIL-6R）和可溶性糖蛋白130（sgp130）浓度及与冠状动脉粥样硬化严重程度间的关系。方法：纳入2017年1月到2019年1月间于惠州市第六人民医院心内科具有动脉造影适应症疑似冠心病患者89例，根据冠状动脉造影结果将患者分成两组：存在冠状动脉粥样斑块CAD组，即粥样斑块组，共64例；不存在冠状动脉粥样斑块CAD组，即非粥样斑块组，共25例。采用ELISA法检测两组患者血清IL-6、sIL-6R和sgp130浓度，Spearman相关分析sgp130浓度与受累冠脉数目及Gensini评分的相关性，多因素logistic回归分析冠状动脉粥样硬化斑块病变的预测因子。结果： 粥样斑块组与非粥样斑块组在年龄、BMI、高血压、糖尿病、血脂参数上无统计学差异（P>0.05）, 粥样斑块组患者男性吸烟者居多（P<0.05）。粥样斑块组血清sgp130浓度显著低于非粥样斑块组（314.97±84.39 VS 399.08±79.99 ng/ml, P<0.001），粥样斑块组血清IL-6浓度显著高于非粥样斑块组（P<0.05）, 粥样斑块组血清sIL-6R浓度和C-反应蛋白浓度(CRP)与非粥样斑块组比较差异无统计学意义。多因素logistic回归分析示血清sgp130浓度是冠状动脉粥样硬化斑块病变存在的预测因子（P=0.018）。血清sgp130浓度与受累冠状动脉数目间呈负相关（r=-0.310，P=0.007），Gensini评分指数与血清sgp130浓度呈负相关（r=-0.410, P=0.001），稳定型CAD患者sgp130浓度是Gensini评分指数独立危险因素。结论：稳定型CAD患者血清sgp130浓度与冠状动脉损伤严重程度呈负相关，血清sgp130水平是冠状动脉粥样硬化严重程度血清标志物。

Relationship between soluble glycoprotein 130 and severity of coronary atherosclerosis in patients with stable coronary artery disease

Objective: To evaluate the relationship between the concentrations of Interleukin-6(IL-6), soluble IL-6 receptor (sIL-6R) and soluble gp130 protein(sgp130) in the patients with stable coronary artery disease (CAD) and the severity of coronary atherosclerosis. Methods: From January 2017 to January 2019, 89 patients with suspected coronary heart disease with angiographic indications were enrolled in the Department of Cardiology, Huizhou Sixth People''s Hospital. According to the results of coronary angiography, the patients were divided into two groups: the CAD group with coronary atherosclerotic plaque (64 cases) and the CAD group without coronary atherosclerotic plaque (25 cases). ELISA method was used to detect plasma IL-6, sIL-6R and sgp130 concentrations in these two groups patients. Spearman correlation analysis was used to analyze the correlation between sgp130 concentration and the number of involved coronary arteries and Gensini score. Multivariate logistic regression was used to analyze the predictors of coronary atherosclerotic plaque lesions. Results: There was no significant difference in age, BMI, hypertension, diabetes mellitus and blood lipid parameters between atherosclerotic plaque group and non-atherosclerotic plaque group (P > 0.05). The majority of male smokers in atherosclerotic plaque group were smokers (P < 0.05). Serum sgp130 concentration in atherosclerotic plaque group was significantly lower than that in non-atherosclerotic plaque group (314.97 +84.39 VS 399.08 +79.99 ng/ml, P < 0.001). Serum IL-6 concentration in atherosclerotic plaque group was significantly higher than that in non-atherosclerotic plaque group (P < 0.05). There was no significant difference in serum sIL-6R concentration and C-reactive protein concentration (CRP) between atherosclerotic plaque group and non-atherosclerotic plaque group. Multivariate logistic regression analysis showed that serum sgp130 concentration was a predictor of the presence of coronary atherosclerotic plaque lesions (P=0.018). Serum sgp130 concentration was negatively correlated with the number of coronary arteries involved (r=-0.310, P=0.007). Gensini score index was negatively correlated with serum sgp130 concentration (r=-0.410, P=0.001). The concentration of sgp130 in stable CAD patients was an independent risk factor of Gensini score index. Conclusion: Serum sgp130 level was negatively correlated with severity of coronary artery injury in patients with stable CAD. Serum sgp130 level was a serum marker of severity of coronary atherosclerosis.