血清高敏C反应蛋白和1-磷酸鞘氨醇水平与冠心病严重程度的相关性研究

目的探讨血清高敏C反应蛋白(hs-CRP)和1-磷酸鞘氨醇(S1P)与冠心病的相关性。方法将122例行冠状动脉造影的患者分为对照组(59例)、冠心病组(63例),用Leaman积分系统对冠状动脉狭窄程度进行评分。采用多因素分析方法探讨冠心病及Leaman积分与血清hs-CRP、血浆中S1P、HDL相关S1P和non-HDL相关S1P含量因素的相关性。结果 (1)冠心病组hs-CRP水平明显高于对照组(7.10±3.37)mg/L比(1.91±2.12)mg/L,P=0.014];冠心病组Leaman评分值明显高于对照组(10.45±5.25)分比(3.25±2.35)分,P<0.01];(2)冠心病组血浆S1P水平高于对照组(415.90±211.08)pmol/ml比(326.45±153.76)pmol/ml,P=0.046],冠心病组HDL-S1P水平与对照组比较,差异无统计学意义(209.38±142.57)pmol/ml比(225.01±102.00)pmol/ml,P=0.072],冠心病组non-HDL-S1P水平明显高于对照组(61.41±73.65)pmol/ml和(7.61±6.76)pmol/ml,P<0.01];(3)Logistic回归分析显示,吸烟、糖尿病、TG、LDL-C、non-HDL-S1P和hs-CRP与冠心病独立相关,而HDL-S1P与冠心病无相关性;(4)冠状动脉Leaman积分的多元逐步回归分析显示,non-HDL-S1P和hs-CRP与冠状动脉积分独立相关,其中以hs-CRP最为明显。结论 hs-CRP和nonHDL相关S1P为冠心病的独立危险因素,且与冠心病严重程度独立相关。

Relationship between serum high sensitivity C-reactive protein,sphingosine 1-phosphate and the severity of coronary heart disease

Objective To investigate the relationship between serum high sensitivity C-reactive protein （hs-CRP） , sphingosine 1-phosphate （S1P） and the severity of coronary heart disease （CHD）. Methods A total of 122 patients underwent coronary angiography were divided into control group （n = 59） and CHD group （ n = 63 ）. Leaman points system were used for the severity evaluation for coronary stenosis. Logistic and multivariate regression analysis was performed to explore related risk factors. Results （ 1 ） Serum Hs-CRP level was significantly higher in CHD group than in control group （7.10 ±3.37）mg/L vs. （1.91 ±2. 12）rag/L, P--0. 014 ]. Leaman coronary score was significantly higher in CHD group than in control group （10.45 ±5.25） vs. （3.25 ±2.35）points, P 〈0.01）. （2） Plasma SIP level was significantly higher in CHD group than in control group （415.90 ± 211.08）pmol/ml vs. （326.45 ± 153.76） pmol/ml, P =0. 046） 1. HDL-S1P level was similar in CHD group and control group （209. 38 ± 142. 57 ）pmol/ml vs. （225.01± 102. 00）pmol/ml, P = 0. 072） 1, and non-HDL-S1P level was significantly higher in CHD group than in control group （ 61.41 ± 73.65 ） pmol/ml vs. （7. 612 ± 6. 76） pmol/ml, P 〈0. 01 ]. （3）Logistic regression analysis showed that smoking, diabetes, TG, LDL, non-HDL associated S1P and hs-CRP were independently associated with CHD. （4） Multivariate regression analysis showed that non- HDL associated SIP and hs-CRP was independently associated with coronary score. Conclusions C-reactive protein and non-HDL associated SIP are independent risk factors of CHD and independently associated with CHD severity.