脉压指数、血浆脂联素与冠心病的相关性

目的探讨脉压指数（PPI）、血浆脂联素（APN）水平与冠心病严重程度的相关性。方法随机收集选择我院行冠状动脉造影患者共146例,冠状动脉病变的严重程度分别用冠脉病变的血管支数、冠脉狭窄程度和冠脉病变积分表示。行24h动态血压监测,计算PPI以及测量身高、体重计算体重指数（BMI）。采用ELISA试剂盒检测血浆APN水平,同时检测患者生化指标,如空腹血糖（FPG）、TC、TG、LDL-C、HDL-C等。结果冠脉病变程度随年龄而逐渐加重,冠脉狭窄积分多支病变组〉两支病变组〉单支病变组〉冠脉正常组;PPI冠脉病变组〉冠脉正常组,多支病变组〉两支病变组〉单支病变组（P〈0.05）;血浆APN水平多支病变组〈两支病变组〈冠脉正常组,多支病变组〈两支病变组〈单支病变组（P〈0.05）;直线相关分析结果表明年龄、BMI、PPI、FPG与冠心病的发生呈显著正相关,血浆APN与冠心病的发生呈显著负相关,血浆APN水平与年龄、PPI呈负相关;多因素Logistic回归分析结果显示：PPI、APN、年龄是冠状动脉病变程度的危险因素。结论脉压指数、血浆脂联素与冠状动脉病变的严重程度密切相关,血浆APN与PPI呈负相关,两者联合检测对冠心病的严重程度及危险性评估和预后有一定的价值。

Relationship between pulse pressure index, the level of plasma adiponectin and coronary heart disease

Objective To explore the relationship among the level of plasma adiponectin, pulse pressure index and coronary heart disease (CHD). Methods 146 patients who underwent coronary angiography were selected randomly. The severity of coronary artery stenosis was reflected by the coronary number with stenosis, the degree of coronary stenosis and score of coronary lesion. 24 h ambulatory systolic blood pressure, diastolic blood pressure and PPI were measured. Measurement of height and weight, calculating body mass index (BMI) were performed. Fasting venous blood was drawn to detect the plasma levels of APN by ELISA, fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C). Results The severity of coronary artery stenosis increased with aging. There was a trend of increase of the score of coronary lesion in the non-CHD group, single-branch group, double-branch group, and multiply-branch group; PPI was significantly different between CHD group and non-CHD group. PPI was significant a trend of increase in the single-branch group, double-branch group and multiply-branch group (P<0.05). The concentration of APN in double-branch group and multiply-branch group were significantly lower than those in the control group; APN was significant a trend of decrease in the single-branch group, double-branch group and multiply-branch group (P<0.05). The occurrence of CHD was significantly positively correlated with age, BMI, PPI and FPG, and negatively correlated with the plasma APN. The plasma APN levels were negatively and significantly correlated with age and PPI. Age, PPI and APN were risk factors of CHD. Conclusion PPI and APN are closely correlated with the severity of CHD; the plasma APN levels were negatively correlated with PPI. APN combined with PPI could provide a new and convenient way for revaluating the severity, risk and prognosis of CHD.