冠心病患者血清乳凝集素、超敏C反应蛋白等指标与严重程度的相关性

目的 检测不同病变程度的冠心病(CHD)患者及冠脉造影阴性者血清乳凝集素(lactadherin)、超敏C反应蛋白(hs-CRP)及血脂等指标,探讨其与CHD病变程度的关系.方法 收集2015年5~10月在武汉大学人民医院心内科行冠脉造影的356例患者,根据造影结果 分为CHD组(n=222)和冠脉造影阴性组(对照组,n=134).其中CHD组根据造影结果又分为单支病变组(n=25)、双支病变组(n=54)和多支病变组(n=143).同时以Gensini评分计算CHD患者病变程度.检测各组受检者的乳凝集素、hs-CRP和血脂等指标,分析各指标与病变支数、Gensini积分之间的关系.结果CHD组患者的乳凝集素水平为(136.22±8.43)ng/mL,显著低于对照组的(577.90±130.02)ng/mL,而CHD组患者的hs-CRP水平为(6.81±0.73)mg/dL,显著高于对照组的(2.56±0.29)mg/dL,差异均具有显著统计学意义(P<0.01).双支病变组患者的乳凝集素水平和高密度脂蛋白胆固醇(HDL-C)水平分别为(172.95±10.28)ng/mL和(0.96±0.02)mmol/L,多支病变组患者的乳凝集素和HDL-C水平分别为(123.64±6.65)ng/mL和(0.99±0.02)mmol/L,两组均显著低于单支组患者的(221.23±12.15)ng/mL和(1.08±0.03)mmol/L,差异均具有统计学意义(P<0.05).多支病变组患者的hs-CRP水平为(7.22±0.78)mg/dL,显著高于单支组的(4.04±0.53)mg/dL和双支组的(4.11±0.47)mg/dL,差异均具有显著统计学意义(P<0.01).多支病变组患者的乳凝集素水平为(123.64±6.65)ng/mL,显著低于双支组的(172.95±10.28)ng/mL,差异具有显著统计学意义(P<0.01).Pearson相关性分析显示,血清乳凝集素水平与Gensini评分、hs-CRP呈显著负相关(r分别为-0.599、-0.313,P均<0.01),hs-CRP与Gensini评分呈显著正相关(r=0.368,P<0.01).结论 乳凝集素水平降低、hs-CRP水平升高与CHD的严重程度密切相关,乳凝集素越低、hs-CRP越高,则CHD的病变程度越严重.

Correlation of serum lactadherin,high-sensitivity C-reactive protein,blood lipid with severity of coronary heart disease.

Objective To measure the levels of serum lactadherin, high-sensitivity C-reactive protein (hs-CRP) and blood lipid in coronary heart disease (CHD), and to discuss the relationship between these indexes and the severity of CHD. Methods From May 2015 to Oct. 2015, 356 patients in Department of Cardiovascular Medicine in our hospi-tal were divided into CHD group (n=222) and control group (n=134, negative results in coronary angiography), accord-ing to the results of coronary angiography. The CHD group was further divided into single vessel disease group (n=25), double vessel disease group (n=54) and multiple vessel disease group (n=143). At the same time, Gensini score was used to calculate the degree of pathological changes of CHD patients. The indexes of lactadherin, hs-CRP and blood lipid were detected, and then the relationships between each index and the number of diseased vessels or Gensini score were analyzed. Results The levels of lactadherin, hs-CRP in CHD group were (136.22 ± 8.43) ng/mL, (6.81 ± 0.73) mg/dL, as compared with (577.90±130.02) ng/mL, (2.56±0.29) mg/dL in the control group (P<0.01). The levels of lactadherin, high-density lipoprotein cholesterol (HDL-C) were (172.95±10.28) ng/mL, (0.96±0.02) mmol/L in the dou-ble vessel disease group and (123.64 ± 6.65) ng/mL, (0.99 ± 0.02) mmol/L in the multiple vessel disease group, as com-pared with (221.23±12.15) ng/mL, (1.08±0.03) mmol/L in single vessel disease group (all P<0.05). The level of hs-CRP was (7.22 ± 0.78) mg/dL in the multiple vessel disease group, which was significantly higher than (4.04 ± 0.53) mg/dL in the single vessel disease group and (4.11±0.47) mg/dL in double vessel disease group (all P<0.01). The level of lactad-herin was (123.64 ± 6.65) ng/mL in the multiple vessel disease group, which were significantly lower than (172.95 ± 10.28) ng/mL in the double vessel disease group (P<0.01). Pearson correlation analysis showed that serum lactadherin has a significantly negative correlation with Gensini score and level of hs-CRP (r=-0.599,-0.313 respectively, P<0.01), and serum hs-CRP has a significantly positive correlation with Gensini score (r=0.368, P<0.01). Conclusion The level of lactadherin and hs-CRP are closely related to the severity of CHD. Lower serum lactadherin and higher hs-CRP were associated with increased severity of CHD.