冠心病患者血浆脂联素炎 性反应因子与冠状动脉病变程度的相关性

目的探讨冠心病患者脂联素（APN）和炎性反应因子水平及其与冠状动脉病变程度的关系。方法经冠状动脉造影确诊冠心病患者85例，冠状动脉病变程度用病变血管支数和Gensini积分表示，包括冠脉病变支数单支病变28例，双支病变35例，三支病变22例；Gensini积分4～18分16例，～29分13例、～48分13例，～176分13例，对照组20例经冠状动脉造影排除冠心病。测定血糖（FPG）、脂类、体质量指数（BMI）、血清脂联素、高敏c反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）和白细胞介素-1β（IL-1β）。结果冠心病患者血清APN水平显著低于对照组，而hs-CRP、TNF—α均高于健康对照组。血清APN与hs-CRP、TNF—α、IL—1β均成负相关（P〈0．05）。结论脂联素的减少与冠心病的发生、发展以及冠状动脉粥样硬化斑块的不稳定性有一定的关系，可能通过拮抗炎性反应因子对血管的损伤来保护血管内皮抗动脉粥样硬化反应。

Correlation of adiponectin, inflammatory factors with severity of coronary artery disease in patients with CHD

Objective The aim of this study was to explore the correlation of adiponectin, inflammatory factors with severity of coronary artery disease in patients with coronary heart disease （CHD）. Methods 85 CHD patients definitely diagnosed by coronary angiography （CAG） were included. The complexity of coronary artery lesion was evaluated by the numbers of suffered coronary branches and Gensini score. The CHD patients were further divided into subgroups according to the number of suffered coronary branches and Gensini score. 20 subjects without CAD diagnosed by CAG were enrolled into control group. Fasting plasma glucose （FPG）, lipids （TC, TG, LDL-C and HDL-C）, body mass index （BMI）, serum adiponectin （APN）, high sensitivity C reactive protein （hs-CRP）, tumor necrosis factor alpha （TNF-α） and interleukin-1 beta （IL-1β） were all measured. Results The serum adiponectin level in CHD patients was significantly lower than that in control group, but hs-CRP, TNF-α levels were markedly higher than that in control group. There was significantly negative correlation between plasma adiponectin and each of the levels of hs-CRP, TNF-α and IL-1β（P〈0.05）. Conclusion The decreased plasma adiponectin level might be associated with the occurrence and severity of coronary atherosclerosis and the unstability of plaque. The plasma adiponectin may antagonize the inflammatory factors and relieve the lesion of coronary artery, which contributes to the prevention of atherosclerosis.