血浆补体因子H、超敏C反应蛋白和胰岛素抵抗与冠心病的关系  

Relationship of plasma concentration of complement factor H,high sensitive C-reactive protein,insulin resistance and coronary artery disease

作　　者：钱琦[1] 陈忠[2] 马根山[2] 冯毅[2] 沈成兴[2] 丁建东[2] 戴启明[2] 童嘉毅[2] 陈学军[1] 

机构地区：[1]东南大学临床医学院,南京210009 [2]东南大学临床医学院附属中大医院心脏病科,南京210009

出　　处：《江苏医药》2009年第4期382-384,共3页Jiangsu Medical Journal

基　　金：江苏省科技厅社会发展项目(BS2007047)

摘　　要：目的研究血浆补体因子H(CFH)、超敏C反应蛋白(hsCRP)和胰岛素抵抗(IR)与冠心病(CAD)关系。方法采用JUdkins法行冠状动脉造影(CAG),排除冠心病(非冠心病组)204例,确诊冠心病155例。其中,冠脉病变血管1支组80例、2支组41例、3支组34例;按临床亚型可分稳定型心绞痛(SA)组62例、不稳定型心绞痛(UA)组69例和心肌梗死(MI)组24例。应用酶联免疫法测定血浆CFH浓度、Backman生化分析仪测定hsCRP、空腹血糖、胰岛素和血脂等指标。根据HOMA Model计算IR指数(IRI)。结果冠心病组IRI明显高于非冠心病组(3.89±1.89 vs 3.40±1.80)(P<0.05),MI组IRI(4.39±2.62)、UA组IRI(4.36±1.61)均明显高于SA组(3.19±1.14),(P<0.05);校正年龄、性别、吸烟史、高血压史和冠心病家族史后,hsCRP是冠心病的独立危险因素(OR:1.417,95%CI:1.236～1.625,P<0.05);IR与hsCRP的相关系数r为0.186,P<0.01。血浆CFH浓度在组间无差别。三个指标在不同病变血管支数组中没有差别。结论hsCRP为冠心病的独立危险因子,IR可以预测冠心病,CFH与冠心病无关。Objective To study the relationship of complement factor H （CFH）, inflammation ,insulin resistance （IR） and coronary artery disease（CAD）. Methods One hundred and fifty-five CAD patients diagnosed by Judkins coronary angiography（CAG） were compared with 204 controls. Fasting plasma glucose,insulin,lipids,serum levels of high sensitive C-reactive protein （hsCRP） and CFH were measured. Insulin resistance was calculated using HOMA-IR model. Results HOMA-IR concentrations were higher in CAD group than those in control group （3.89± 1.89 vs 3. 40± 1.80）（ P〈0.05） and were higher in myocardial infarction group（MI, 4.39±2.62）and unstable angina group （UA,4.36±1.61）than those in stable angina group （SA,3.19±1.14）, （P〈0.05）. Concentration of serum hsCRP was significantly higher in CAD group than that in control group. After corrected by age, sex and the histories of smoking, hypertension and family, only hsCRP was correlated with CAD. Plasma CFH levels had no correlation with CAD. The HOMA-IR was significantly correlated with serum hsCRP concentration （r=0. 186, P〈0.001）. There was no association among three markers and the diseased vessels. Conclusion hsCRP is associated with CAD, IR can predict the presence of CAD, and there is no association between CFH levels and CAD.

关 键 词：补体因子H 超敏C反应蛋白 胰岛素抵抗 冠心病 

分 类 号：R541[医药卫生—心血管疾病]