急性冠脉综合征患者血清OPG、sRANKL、OPG/sRANKL比值与冠状动脉粥样硬化斑块稳定程度的相关性

目的:探讨急性冠脉综合征（ACS）患者血清骨保护素（osteoprotegerin,OPG）及其配体（souble-RANKL，sRANKL）和OPG/sRANKL比值与冠状动脉粥样硬化稳定程度的相关性。方法: 纳入研究者分成3组:ACS患者（335例）、稳定型心绞痛（SAP）患者（120例）与正常对照组（120例）。其中ACS组又分为不稳定心绞痛（UAP组）134例，非ST段抬高型心肌梗死（NSTEMI组）80例以及ST段抬高型心肌梗死（STEMI）组121例3组。通过ELISA检测其血清OPG和sRANKL水平，并将二者血清水平及比值（OPG/sRANKL）与ACS冠状动脉粥样硬化斑块稳定程度进行比较分析。结果: ACS、SAP及对照组3组间血清OPG、sRANKL、OPG/sRANKL比值均有显著差异（均P<0.01）。 ACS组内3组血清OPG、sRANKL、OPG/sRANKL比值也均有显著差异（均P<0.05）,其中STEMI组与UAP组有显著差异（P<0.05），UAP组与NSTEMI组、NSTEMI与STEMI组间无显著差异。 冠脉Gensini积分与血清OPG水平呈正相关（r=0.252，P<0.01），与OPG/sRANKL呈正相关（r=0.284，P<0.01），与血清sRANKL水平呈负相关（r=-0.235，P<0.05）。结论: 血清OPG、sRANKL、OPG/sRANK比值与ACS病情及冠状动脉粥样硬化斑块稳定程度有关联。

Relationship between levels/ratios of serum osteoprotegerin and sRANKL and stabilization of coronary artery atherosclerosis in patients with acute coronary syndrome

AIM:To analyze the relationship between the osteoprotegerin (OPG) system and stabilization of coronary artery atherosclerosis in patients with acute coronary syndrome (ACS). METHODS: A total of 575 consecutive patients were divided into three groups: ACS group (n=335), stable angina (SA) group (n=120) and control group (n=120). ACS group was subdivided into unstable angina (UA) group of 134 patients, non-ST-segment elevation myocardial infarction (NSTMI) group of 80 patients and ST-segment elevation myocardial infarction (STMI) group of 121 patients. Serum OPG and its ligand (souble-RANKL, sRANKL) levels were measured by enzyme-linked immunosorbent assay (ELISA). The relationship between levels of OPG and sRANKL as well as the ratio of the two (OPG/sRANKL) and stabilization of coronary artery atherosclerosis was investigated. RESULTS: Serum OPG, sRANKL, and OPG/sRANKL ratios were different between ACS, SA and control groups (P<0.01). Serum OPG, sRANKL and OPG/sRANKL ratios were different among the three subgroups of ACS group (P<0.05). The difference between STMI group and UA group was significant (P<0.05). The difference between UA group and NSTMI group and the difference between NSTMI group and STMI group were not significant. Gensini coronary points were positively correlated with both serum OPG levels (r=0.252, P<0.01) and OPG/sRANKL (r=-0.284, P<0.01), but negatively correlated with serum sRANKL levels (r=-0.235, P<0.05). CONCLUSION: OPG and sRANKL levels and the ratio of the two (OPG/sRANKL) are associated with the stabilization of coronary artery atherosclerosis in patients with ACS.