冠心病患者血清中25羟维生素D3、内皮型一氧化氮合酶水平及意义

目的：检测25羟维生素D325-(OH)D3]、内皮型一氧化氮合酶（eNOS）在冠心病（CHD）患者血清中的表达情况，探讨二者在CHD患者发病程度中的关系及作用。方法：选取2017年9月至2019年6月在本院收治的CHD患者96例作为研究对象，按照冠状动脉病变狭窄的严重程度将其分为病变Ⅰ级（22例）、病变ⅠⅠ级（29例）、病变ⅠⅠⅠ级（25例）和病变Ⅳ级（20例），选取同期健康体检者100例作为对照。分别采集CHD患者和健康体检者外周血并分离出血清，利用酶联免疫吸附法（ELISA）检测血清中25-(OH)D3、eNOS的表达水平，使用全自动生化分析仪分析血脂指标总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）以及高密度脂蛋白胆固醇（HDL-C）水平，并分析CHD患者血清中25-(OH)D3、eNOS水平与TC、TG、LDL-C、HDL-C的相关性。结果：与对照组相比，CHD组患者血清中25-(OH)D3、eNOS和HDL-C水平均明显降低，TC、TG、LDL-C均明显升高（P＜0.05）；随着CHD患者冠状动脉病变狭窄的加重，CHD组患者血清中25-(OH)D3、eNOS表达水平和HDL-C水平均明显降低，TC、TG、LDL-C均明显升高（P＜0.05）；CHD患者血清中25-(OH)D3、eNOS的表达水平与TC水平均明显负相关（P＜0.05），与HDL-C水平均明显正相关（P＜0.05），与TG水平负相关均不明显（P＞0.05），此外，25-(OH)D3水平与LDL-C水平明显负相关（P＜0.05），eNOS的表达水平与LDL-C水平负相关不明显（P＜0.05）。结论：CHD组患者血清中25-(OH)D3、eNOS表达均明显下调，其表达水平均随着CHD组患者冠状动脉病变程度的加重而下调，且与血脂指标关系密切，可作为CHD诊断、治疗和预后的分子标志物。

Levels and significances of serum 25-hydroxyvitamin D3 and endothelial nitric oxide synthase in patients with coronary heart disease

Objective: To detect the expressions of 25-hydroxyvitamin D3 25-(OH)D3], endothelial nitric oxide synthase (eNOS) in serum of patients with coronary heart disease (CHD), and to explore the relationships between them and the severity of CHD. Methods: 96 CHD patients admitted to our hospital from September 2017 to June 2019 were selected as the research objects. According to the severity of coronary artery stenosis, 96 CHD patients were divided into lesion grade I (22 cases), lesion grade I (29 cases), lesion grade I (25 cases) and lesion grade IV (20 cases). 100 healthy examinees in the same period were selected as controls. Peripheral blood samples were collected from CHD patients and healthy people, hemorrhagic serum was separated, the expression levels of 25-(OH)D3 and eNOS in serum were detected by enzyme-linked immunosorbent assay (ELISA), the levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were analyzed by automatic biochemical analyzer, and the correlations of serum 25-(OH)D3 and eNOS levels with TC, TG, LDL-C and HDL-C in CHD patients were analyzed. Results: Compared with the control group, the levels of serum 25-(OH)D3, eNOS and HDL-C in CHD group were significantly lower, while TC, TG and LDL-C were significantly higher (P < 0.05). With the aggravation of coronary stenosis in CHD patients, the levels of serum 25-(OH)D3, eNOS and HDL-C in CHD patients decreased significantly, while the levels of TC, TG and LDL-C increased significantly (P < 0.05). The expression levels of 25-(OH)D3 and eNOS in serum of CHD patients were negatively correlated with TC level (P<0.05), positively correlated with HDL-C level (P<0.05), negatively correlated with TG level, while the differences were not significant (P>0.05), in addition, 25-(OH)D3 level was negatively correlated with LDL-C level (P<0.05), the expression level of eNOS was negatively correlated with the level of LDL-C, but not significantly (P<0.05). Conclusions: The expressions of 25-(OH)D3 and eNOS in serum of patients with CHD are significantly decreased, and they are down-regulated with the severity of coronary artery disease in patients with CHD, which are closely related to blood lipid index, and could be used as molecular markers for the diagnosis, treatment and prognosis of CHD.